Job stress does not contribute to chronic high blood pressure

yeahright

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Job stress does not contribute to chronic high blood pressure


2006 MAY 29 -- Many people believe that ongoing hassles at work are a real threat to health because they can raise blood pressure over the long term but they are wrong. The most comprehensive review of the literature on the subject ever conducted finds little evidence that day-to-day work woes affect chronic blood pressure, one way or the other.

"It's long been a cherished notion that chronic stress -- in this case, job stress -- contributes to hypertension. It's time to set the record straight, however," said Dr. Samuel J. Mann, professor of clinical medicine at Weill Medical College of Cornell University and a hypertension specialist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York City.

"When you realize that doctors may be advising patients to quit or change jobs to help them avoid hypertension, it's clear that this misconception can have life-altering effects," Dr. Mann points out.

His review of dozens of studies on the subject, published in a recent issue of Current Hypertension Reviews, finds that the evidence that workplace stress has a lasting effect on blood pressure is very weak and very inconsistent.

His review was spurred, in part, by a very rigorous study published in 2003 by a team of French researchers in the prestigious journal, Hypertension.

That study found no effect of job strain on hypertension. "So, I wondered, if this very large, well-conducted trial found nothing, why did smaller trials sometimes say otherwise?" Dr. Mann said.

In his review, Dr. Mann analyzed data from 48 studies on job stress and blood pressure, all published in English-language journals from 1982 to 2004. Overall, more than 100,000 people were included in the trials. Dr. Mann found that most studies actually found no relationship between job stress and blood pressure, and that findings were very weak in most of the studies that did report a relationship.

"For example, researchers would sometimes find no overall effect of job stress on blood pressure, but would then report a relationship limited to a small subgroup of the study population," he said.

"The trouble was that if any specific subgroup was particularly susceptible, you'd expect to see that subgroup crop up across studies. None did."

In other studies, the authors would focus on a weak relationship found between blood pressure and one measure of job stress, while ignoring the absence of a relationship with all other job stress measures assessed.

Another flaw? Inexplicably, some studies found that job strain affected diastolic blood pressure -- the bottom number in a reading -- but didn't affect the systolic pressure (the top number) at all. In fact, two studies neglected to even mention systolic pressure.

"This is all very odd, since clinicians know that systolic pressure varies more widely than diastolic pressure. It's also a more reliable marker of cardiovascular risk compared to diastolic readings," Dr. Mann said. "The omission of systolic pressure in those studies' data is troubling," he adds.

Finally, most trials that have looked at potential remedies for chronic stress -- particularly stress reduction techniques -- found that they did not lower blood pressure levels. "This suggests, of course, that the job stress wasn't causing the hypertension in the first place," Dr. Mann said.

He stressed that he in no way disagrees with the notion that clashes with co-workers can boost blood pressure over the short-term -- minutes or hours.

"Furthermore, reliable studies have shown that ongoing difficulties at work can contribute to coronary artery disease," Dr. Mann adds. "That appears to be true, but blood pressure does not seem to be the link between the two."

So, if the evidence suggests otherwise, why does the idea that job strain is a contributor to high blood pressure persist among researchers, clinicians and the general public?

"Mainly because there is no doubt that stress can elevate blood pressure in the moment. But the corollary that recurring stress leads to sustained blood pressure elevation has not been demonstrated, despite decades of research that aimed to prove it. It's hard not to think that many researchers -- for a variety of reasons -- have a vested interest in keeping this notion alive, and that they publish articles that strain to support their view," Dr. Mann said.

"However, as scientists, we need to get better at weeding out faulty data and prove that, in this case at least, the 'emperor has no clothes.'"

This article was prepared by NewsRx editors from staff and other reports. Copyright 2006, NewsRx.com.
 
Jayhawkk

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I know for a fact this is BS! One guy chimes in with, "let's set the record straight.", and thinks that all the other crap saying otherwise is wrong? The variable here is that some people can tolerate or have an ability to toss away some of the stress vs. others but either directly or indirectly, stress affects more than just High Bloodpressure.
 
yeahright

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I know for a fact this is BS! One guy chimes in with, "let's set the record straight.", and thinks that all the other crap saying otherwise is wrong? The variable here is that some people can tolerate or have an ability to toss away some of the stress vs. others but either directly or indirectly, stress affects more than just High Bloodpressure.
Well, you have two points here.

The first is addressed in their meta-analysis where they cite 48 studies on job stress and blood pressure, all published in English-language journals from 1982 to 2004 covering more than 100,000 people and find zero evidence for the proposition that workplace stress causes high blood pressure.

The second point you make (stress affects more than just High Bloodpressure) they explicitly acknowledge towards the end of the article. "Furthermore, reliable studies have shown that ongoing difficulties at work can contribute to coronary artery disease," Dr. Mann adds.

They're not saying that stress doesn't have negative health effects (they acknowledge that it does), they're just saying that there's no evidence that it increases high blood pressure.

I don't have a dog in this fight but I find it really interesting when something I've always assumed to be true is actually just an urban legend (according to the research authors).
 
Jayhawkk

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Well I believe it indirectly causes it. If I can have my blood pressure raise by just being in a doctors office then telling me that it can't be raised by continual high stress wouldn't as well.
 
yeahright

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Well I believe it indirectly causes it. If I can have my blood pressure raise by just being in a doctors office then telling me that it can't be raised by continual high stress wouldn't as well.
They differentiate between short-term rises in blood pressure (which they say can be documented to localized stress) and persistent high blood pressure (that which doesn't go down when the stress is removed).
 
Jayhawkk

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Aye, the problem is this, I think. How long does a doctor allow long term high blood pressure to contineu before putting that individual on some type of medication or treatment?
I think having a long term study in this fashion would be a bit dangerous wouldn't you think?
 
yeahright

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The article here is about cause sparky, not treatment of effect. :hammer: The question here is why are people arguing with this study? I hav eno stake in it....for all I know it could be completely wrong.....but "I've always believed this so the study must be wrong" doesn't cut it. I HAVE always believed this but absent evidence to support my belief, I'm going to defer to the experts in the field.
 
Jayhawkk

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Exactly my point. In order to determine if long term stress causes chronic high blood pressure you'd need a patient that's been under stress and proven to be under stress for long periods of time and at the same time not treat them so nothing effects the outcome when the stress is removed. UNless there's another way i'm missing? You're the education one...Enlighten me :)
 
yeahright

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Exactly my point. In order to determine if long term stress causes chronic high blood pressure you'd need a patient that's been under stress and proven to be under stress for long periods of time and at the same time not treat them so nothing effects the outcome when the stress is removed. UNless there's another way i'm missing? You're the education one...Enlighten me :)
You would find two populations of people who are as alike as possible EXCEPT for the variable you're testing for (in this case job stress)....and then compare the differences. If these people are alike except for this one thing, then it's a reasonable conclusion that the one thing caused the differential health outcome.

Apparently, when they looked at dozens of such studies comparing more than 100,000 people, there was no differential health outcome between the high stress and low stress job holders.
 
Jayhawkk

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Hmm, well not all people in high stress jobs have high blood pressure and not everyone in low stress jobs have low blood pressure. You'd have to account for stress at home and if they were willing to talk about it(seems a lot do not like saying they're not in control at home) or family etc.

Also, you would, to me, have to show that they all react to the same kinds of stress close to the same...Am i getting closer?
 
jmh80

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Bah!

There are quite a few that can put it where the sun don't shine!
 
yeahright

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Hmm, well not all people in high stress jobs have high blood pressure and not everyone in low stress jobs have low blood pressure. You'd have to account for stress at home and if they were willing to talk about it(seems a lot do not like saying they're not in control at home) or family etc.

Also, you would, to me, have to show that they all react to the same kinds of stress close to the same...Am i getting closer?
No. You control for as many variables as you can but then you let statistics sort it out. If you look at enough people, you'll get composite numbers that wash-out localized deviations. In a population that size, you can assume that those other factors are spread more or less in the same percentages through both groups (the high stress job and low stress job holders). If you look at 100,000 people and the answer all comes out one way, then you don't need to worry about those other things. They're irrelevant to the question at issue.
 
Jayhawkk

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I just wrote a long reply but deleted it :)


I'm going to have to stand my ground that high continual stress has to either directly or indirectly cause, by starting unhealthy habits to cope with the stress, chronic blood pressure. I know what stress is able to do to the human body. Fro mild irritation to making your body think it's injured and causing all kinds of damage.


I guess it neother matters one way or another for me since I have yet to see a way to eliminate all stress from someone besides them dying. So even if chronic is the wrong word, it does cause regular high blood pressure and that is enough to kill ya the same way, just with a less fancy name :p
 

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