Cardiovascular disease (CVD) accounts for 43% of all deaths in the U.S. Hypertension affects as many as 50 million Americans, however the causes of essential hypertension are not well known. A new CVD risk factor (""""""""job strain"""""""") has emerged as a potential major cause of essential hypertension. Over 20 studies have found significant positive relationships between """"""""job strain"""""""" and CVD, coronary heart disease, all-cause mortality or hypertension. """"""""Job strain"""""""" is defined as high psychological workload demands combined with low""""""""decision latitude"""""""". An expanded concept of """"""""job strain"""""""" which includes low workplace social support (""""""""iso-strain"""""""") has been developed and will be examined in the proposed study. Important questions remain to be answered about """"""""job strain"""""""", CVD and hypertension. In most studies, """"""""job strain"""""""" was only measured at one point in time, while, in fact, cumulative exposure to """"""""job strain"""""""" is believed to be the risk factor. In addition, most studies have relied on self-report measures of """"""""job strain"""""""". Also, no studies have specifically examined risk of stroke and """"""""job strain"""""""".
Key research aims are not addressed by current funding of the Cornell University cohort study of psychosocial Factors and Cardiovascular Disease or the Columbia University-Northern Manhattan Stroke Study. Therefore, we request funds for secondary analysis of data from these two studies to address the following five key research aims: A1) Are blood pressure levels associated with cumulative exposure to """"""""job strain""""""""? A2) Are differences in blood pressure increases associated with an objective measure of """"""""job strain""""""""? A3) Is increased risk of stroke associated with an objective measure of """"""""job strain""""""""? A4) Are changes in psychological variables over time associated with job characteristics? A5) Are changes in CVD risk factors (other than hypertension) associated with job characteristics? The P.I. proposes to analysis the association between an objective measure of """"""""job strain"""""""" and risk of stroke, and change in ambulatory blood pressure. He will also construct measures of cumulative exposure to """"""""job strain"""""""" and determine their association with blood pressure, and will analyze the association between job characteristics and change in psychological variables and CVD risk factors. Cornell University study subjects are 38% female and 31% members of minority groups. Columbia University Study subjects are 61% female and 82% members of minority groups.
| Landsbergis, Paul A; Schnall, Peter L; Pickering, Thomas G et al. (2003) Lower socioeconomic status among men in relation to the association between job strain and blood pressure. Scand J Work Environ Health 29:206-15 |
| Landsbergis, Paul A; Schnall, Peter L; Pickering, Thomas G et al. (2003) Life-course exposure to job strain and ambulatory blood pressure in men. Am J Epidemiol 157:998-1006 |
| Landsbergis, Paul A; Schnall, Peter L; Pickering, Thomas G et al. (2002) Validity and reliability of a work history questionnaire derived from the Job Content Questionnaire. J Occup Environ Med 44:1037-47 |
| Friedman, R; Schwartz, J E; Schnall, P L et al. (2001) Psychological variables in hypertension: relationship to casual or ambulatory blood pressure in men. Psychosom Med 63:19-31 |
