Accumulating evidence supports the importance of chronic stress in the development of cardiovasculardisease (CVD). One of the most consistent set of findings in this literature is the research on occupationalstress. A growing literature is consistent with the 'job strain' model, showing that chronic exposure to highlydemanding and uncontrollable work environments may be linked with the development of clinical CVD as wellas subclinical atherosclerosis. Much remains to be understood, however, about the potential mechanismslinking occupational stress and CVD, and the degree to which such mechanisms are specific to the workplace.For example, one assumption of the job strain model is that moment-to-moment behavioral processes accountfor the effects of occupational stress on health. This assumption is difficult to test using standardmethodologies. We have recently developed state-of-the art computer-assisted ambulatory assessmentprocedures that allow us to capture the psychological and biological markers of mental stress over the courseof daily life. Use of these procedures will allow us to examine, more precisely than has previously beenpossible, the mechanisms accounting for the health effects of occupational stress. 530 healthy employees(ages 30-55) will be administered ambulatory blood pressure (ABP) and electronic diary assessments overthree working days and one nonworking (weekend) day. Global assessments of occupational stress will alsobe employed, along with risk factors and biomarkers for CVD, including ultrasound measures of carotid arteryatherosclerosis. We will examine the role of 'daily psychosocial strain,' as assessed in real time in the naturalenvironment, in explaining the association between occupational stress and CVD biomarkers. Both biologicalfactors (hemodynamic and neuroendocrine factors) and health risk behaviors will be examined as potentialmechanisms accounting for these effects, models that have been hypothesized but never explicitly tested. Therole of daily demands outside of the workplace in contributing to the effects of occupational stress will becharacterized, and the patterns of daily living accounting for sex differences in the relationship betweenoccupational stress and biomarkers for CVD will also be examined.
Identifying the behavioral and biological mechanisms by which occupational stress maycontribute to cardiovascular disease is of critical importance for developing appropriate treatment targets andmethods of intervention designed to reduce its effects.
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