Work stress and metabolic and hemostatic risk factors.
OBJECTIVE
A high level of work stress has been associated with cardiovascular disease. However, the pathophysiological mechanisms underlying this association remain unclear. This study examined the effect of work stress on a cluster of metabolic and hemostatic risk factors.


METHODS
Blood was collected three times, on the first, third, and fifth day of a work week, from 124 middle-aged, white-collar workers. Metabolic measures were insulin, glucose, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and total cholesterol. Hemostatic measures were fibrinogen, tissue-type plasminogen activator activity, tissue-type plasminogen activator antigen, and type 1 plasminogen activator inhibitor antigen. Chronic work stress was defined according to Siegrist's model as 1) a combination of high effort and low reward at work (effort-reward imbalance) or 2) high overcommitment (an exhaustive work-related coping style).


RESULTS
Overcommitment, but not imbalance or the imbalance-overcommitment interaction, was associated with an impaired fibrinolytic system, as reflected in decreased tissue-type plasminogen activator activity levels and increased type 1 plasminogen activator inhibitor antigen levels on all three measurement occasions. After controlling for body mass index, total cholesterol, triglycerides, high-density lipoprotein/low-density lipoprotein cholesterol ratio, glucose, and insulin, the relation between overcom-mitment and the fibrinolytic factors was attenuated but remained significant.


CONCLUSIONS
The results suggest that individuals with an exhaustive coping style at work have an impaired fibrinolytic capacity that is possibly due to the effects of chronic stress on insulin resistance.
Vrijkotte
T G
TG
Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands. tanja@psy.vu.nl
van Doornen
L J
LJ
de Geus
E J
EJ
D000223:Adaptation, Psychological; D000328:Adult; D002784:Cholesterol / Q000097:blood*; D005340:Fibrinogen / Q000378:metabolism; D005342:Fibrinolysis; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D010960:Plasminogen Activators / Q000378:metabolism; D012307:Risk Factors; D012494:Sampling Studies; D013315:Stress, Psychological / Q000097:blood*; D010959:Tissue Plasminogen Activator / Q000378:metabolism; D014937:Work
D007328:Insulin; D017395:Plasminogen Activator Inhibitor 1; D005340:Fibrinogen; D002784:Cholesterol; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator