A recent research has shown a clear association between heart disease and stress. This is the result of Whitehall II marathon research led by Sir Michael Marmot, Professor of Epidemiology and Public Health at University College London, UK which has been going since 1985.
In this research 10,308 civil servants were followed in all these years, the study is also first comprehensive study to look into the cardiovascular mechanisms of work stress in the population that lead to Coronary Heart Disease(CHD) either by some changes in the interaction of nervous system and body’s hormones or by unhealthy lifestyle.
Dr Tarani Chandola, a senior lecturer in UCL's Department of Epidemiology and Public Health, who led the study said, “This is the first large study of people in everyday working life, rather than just of chronic burnt-out patients, showing that those who report more stress are also more likely to have certain biological stress responses.”
The researchers studied the death caused by CHD, heart rate variability, rise of stress hormones cortisol, the behavioural risk factors such as diet, exercise, smoking and drinking.
“During 12 years of follow-up, we found that chronic work stress was associated with CHD and this association was stronger among both men and women aged under 50 -- their risk of CHD was an average of 68% more than for people who reported no stress at work. Among people of retirement age (and therefore less likely to be exposed to work stress), the effect on CHD was less strong.”
The most important finding was the linkage between stress and CHD. The Autonomic Nervous System (ANS) regulate the involuntary actions like heart beat also that it has a central role in the neuro-endocrine stress responses. The signal sent to heart to control the variability of the heart is mediated by ANS. It was found that those who suffered more stress have likely to have lower variability of heart rate.
Also the Hypothalamic Pituitary Adrenal Axis which play a major role in neuro-endocrine system get disturb by the stress and result in higher level of cortisol. The result however was independent of health behaviours.
“Adjusting for health behaviours did not change the association between work stress and low heart rate variability, suggesting a direct effect on the ANS and neuro endocrine function, rather than indirect effects through health behaviours,” said Dr Chandola.
“The effect on the ANS and neuro endocrine function in turn affects the signals to the heart, leading to cardiac instability,” he further added.
“There have been relatively few studies that have found an association between work stress and unhealthy behaviours. Work stress is associated with a poorer diet in terms of eating less fruit and vegetables, and less exercise. It has also been linked to problem drinking, although not in this study. In this study, around 32% of the effect of work stress on CHD could be explained by its effect on health behaviours and the metabolic syndrome,” he said.
Thus the study which continued for a number of years says that the stress at workplace can lead to CHD directly by the activity of neuro endocrine system and indirectly to health problems.
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