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Psychosocial and biobehavioral characteristics of hypertensive men with elevated atherogenic lipids
1Department of Medical Sociology, Medical School, University of Marburg, F.R.G.
Insights
Coronary high risk (CHR)-status, a combination of hypertension and high lipids, is linked to overweight, smoking, and workplace factors like low promotion prospects and anger. These factors increase the risk of ischemic heart disease (IHD).
Area of Science:
- Occupational Health
- Cardiovascular Epidemiology
- Psychosocial Medicine
Background:
- Epidemiologic studies show increased ischemic heart disease (IHD) risk in individuals with both hypertension and elevated atherogenic lipids, termed coronary high risk (CHR)-status.
- Factors contributing to CHR-status in early and middle adulthood remain underexplored.
- Understanding these factors is crucial for preventing cardiovascular disease in at-risk populations.
Purpose of the Study:
- To investigate the role of biobehavioral and psychosocial factors in the development of CHR-status.
- To identify predictors of CHR-status in middle-aged male blue-collar workers.
- To validate CHR-status as a predictor of IHD incidence.
Main Methods:
- Prospective cohort study of 416 middle-aged male blue-collar workers over 6.5 years.
- Multivariate logistic regression analysis to assess independent contributions of various factors.
- Analysis of biobehavioral factors (overweight, smoking) and psychosocial factors (work prospects, competitiveness, anger).
Main Results:
- Overweight (OR 4.14), smoking (OR 2.19), low promotion prospects (OR 2.71), work competitiveness (OR 2.79), and sustained anger (OR 5.41) were independent predictors of CHR-status.
- CHR-status demonstrated predictive power for IHD incidence in the cohort.
- Specific work-related characteristics combined with biobehavioral risks significantly increase CHR-status likelihood.
Conclusions:
- Hypertension and elevated lipids (CHR-status) are more prevalent in blue-collar men with specific work-related characteristics and biobehavioral risks like overweight and smoking.
- Findings highlight the importance of occupational and psychosocial factors in cardiovascular risk.
- The results have implications for health policy, particularly for socio-economic strata with high CHR-status and IHD prevalence.
Abstract:
Epidemiologic studies demonstrated an excess risk of ischemic heart disease (IHD) among individuals who simultaneously exhibit hypertension and elevated atherogenic lipids (coronary high risk (CHR)-status). Yet, relatively little is known about factors which contribute to the development of CHR-status during early and middle adulthood. The present study explores the role of selected biobehavioral and psychosocial factors in explaining CHR-status using data from a prospective 6.5 years investigation of a cohort of 416 middle-aged (40.8 +/- 9.6 years) male blue-collar workers. Multivariate logistic regression analysis shows that overweight (odds ratio (o.r.) 4.14), smoking (o.r. 2.19), low promotion prospects at work (o.r. 2.71), competitiveness at work (o.r. 2.79) and feelings of sustained anger (o.r. 5.41) independently contribute to the explanation of CHR-status. Furthermore, the operational definition of CHR-status is validated by estimating its power in predicting IHD incidence in the study cohort. In conclusion, co-manifestation of hypertension and elevated lipids is more likely to exist among those blue-collar men who exhibit distinct work-related characteristics in addition to established biobehavioral risks such as overweight and smoking. In view of the high prevalence of CHR-status and of IHD among men in the lower socio-economic strata this finding is also of interest for health policy.