Does job stress adversely affect blood pressure? Research hasnít provided clear answers. Now a new Australian study suggests that itís what a worker does to cope with stress, not the stress itself, that may raise blood pressure and thus endanger health. The study participants should know about stress in the workplace: they work in a tax office.

ìThere were no direct associations between measures of work stress and blood pressure,î investigators report in the January American Heart Association journal Hypertension. But while job stress per se had no direct effect, ìthe ways that individuals reported coping with stress were significantly related to blood pressure.î People with the highest blood pressure had poor dietary and drinking habits and were physically inactive, the researchers found.

Men in the study had higher average blood pressures than women, despite exercising more. Women were more likely to use healthier ìcopingî mechanisms, while men used more potentially harmful coping strategies, drank more alcohol and ate less healthily than women.

The study by researchers at the University of Western Australia and West Australian Heart and Research Institute in Perth involved 654 healthy Caucasian volunteers, 337 men and 317 women ages 17 to 64, who took part in an on-site health screening program. All were employees of an Australian government tax office who were working under high stress levels because of annual tax return deadlines and changes in their jobs due to restructuring.

Participants completed two detailed questionnaires: One, administered at the workplace, measured job-related stress and stress-related coping strategies. The other, completed by workers at home, assessed lifestyle, health and demographics. Individualsí resting blood pressures were measured a total of 14 times -- seven readings at brief intervals made on each of two occasions a week apart.

To assess employeesí stress levels, researchers administered a questionnaire listing 61 ìpressure pointsî both at work and home that have been shown in earlier research to be potential sources of occupational stress. Topics included ìfactors intrinsic to the job,î ìrelationships with other people,î ìcareer and achievementî and ìhome/work interface.î The respondents were asked to rate each potential pressure point on a 6-point scale ranging from ìdefinitely is notî to ìvery definitely isî a source of pressure.

To measure how well they handled stress, workers were asked to rate, also on a 6-point scale, their use of 28 basic coping strategies, with their responses ranging from ìnever usedî to ìvery extensively used.î Nine additional questions explored specific lifestyle strategies the workers used to cope with stress: ìexercise,î ìeat frequently,î drink coffee, tea, or smoke,î ìhave an alcoholic drink,î ìtake analgesics,î ìuse tranquilizers or other medicine,î ìuse humor,î ìuse relaxation techniques,î and ìtake positive time out.î The researchers gathered details about physical activity, including frequency of vigorous exercise, and dietary habits.

The scientistsí scoring system rated coping mechanisms as either ìmaladaptiveî or ìadaptiveî in a variety of categories that included ìsolution orientedî steps (effective time management, taking time out, delegating); ìexternal/socialî strategies (having stable relationships, hobbies, social support); ìconsumption behaviorî coping (drug and food use); ìpositive attitudinalî coping (relaxation techniques, delegating); and ìavoidance/denialî coping (supressing emotions, using distractions to take mind off things, staying busy).

ìAlthough the results provide no evidence for a direct effect of perceived job stress on blood pressure, they do suggest that there may be indirect influences consequent on the strategies used to cope with stress,î Thalina L. Lindquist, Ph.D., and her colleagues report.

ìMeasures of job stress were significantly related to a number of coping mechanisms influencing lifestyle factors, such as alcohol consumption, physical inactivity, and dietary habits, that with obesity were the dominant factors associated with blood pressure levels in both men and women,î the researchers continue.

The connection between job stress and maladaptive, or unhealthy, coping behaviors were more clearly demonstrated in men than women, especially excessive consumption (food, cigarettes, alcohol) and denial of stress. Menís average systolic (pumping) blood pressures were 8 millimeters of mercury (mm/Hg) higher and diastolic (resting) pressures 3 mm/Hg higher than womenís. Smoking habits did not differ between the sexes.

Along with obesity and other lifestyle factors known to influence blood pressure, coping strategies used to deal with stress should be added to any list of targets for behavioral change programs, the researchers say. Efforts to prevent hypertension in the workplace should focus ìnot only on the working environment but also on the way individuals perceive and cope with stress insofar as this influences behaviors directly predisposing (them) to hypertension.î

Gender differences in coping strategies also need to be addressed, add the investigators.

Other co-authors are Lawrence J. Beilin, M.D., and Matthew W. Knuiman, Ph.D.

Hypertension is one of five scientific journals published by the American Heart Association, which has its national headquarters in Dallas. ### Media advisory: Dr. Beilin and Dr. Lindquist can be reached in Perth by calling 61-9-224-0258 or 61-9-384-7823; fax 61-9-224-0246. Reporters may call (214) 706-1173 for a copy of their journal report. (Please do not publish telephone or fax numbers.)

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