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OCCUPATIONAL STRESS IN PATIENTS WITH CHRONIC CARDIOVASCULAR AND METABOLIC DISORDERS

Prof. Dr. Krystyna Nazar, Prof. dr. Hanna Kaciuba-Uscilko, dr. Ewa Wojcik-Ziolkowska, Prof. Dr. Barbara Kruk

Hypertension, coronary heart disease (CHD), and obesity occur in approx. 20% of  middle aged men employed in a wide variety of work settings. Laboratory  investigations revealed that the patients are  more susceptible to  physical and mental stress than healthy  persons. Since the stress responses may lead to aggravation of their  health status it is of importance to evaluate the impact of psychosocial work conditions on the  time course of blood pressure and cardiac function indices in  patients engaged  in jobs with high mental demands and  extensive responsibility.  In the present study  80 patients with hypertension and/or CHD, aged from 35 to 65 years, were recruited from the Outpatient Cardiac Unit  for Diagnosis and Therapy, MRC. They are  full time employed as business managers, school or university teachers, lawyers, medical doctors, research workers etc. The type of  behavior of the patients  (type A and B)  and conditions of their work were assessed  by  using  respective questionnaires. During 4 separate week days ambulatory blood pressure  and electrocardiogram were recorded for 24 hours using Holter methods. The patients  were asked to choose  two more and two less stressful days, and to make notes of their activities and events during each of these days. The patients' mood status during work time was evaluated on the basis of  ad hoc mood questionnaire.  The pharmacological treatment was not discontinued. For assessment of the patients' stress reactivity the standardized laboratory testing program was elaborated. It includes cardiovascular and hormonal responses to mental stress (arithmetic Kreapelin test), exposure to noise, static hand-grip, and orthostatic maneuver.

By gathering these data interventions can be planned to attenuate the effects of occupational stress on health status  of vulnerable employes with chronic cardiovascular and metabolic  diseases.

This study  is supported  by the Strategic Governmental Program "Safety and Health Protection of Men in Work Environment", grant no 04.10.6.

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