Stress-associated hypertension in the work place : results of the STARLET project
BACKGROUND AND OBJECTIVE: To assess the influence of work stress and initial blood pressure on the prognosis of hypertension.
SUBJECTS AND METHODS: In a prospective, controlled, multicentre, observational study, ambulatory 24-hour blood pressure measurements (ABPM) of employees from different work places were recorded at the work place on working days. Recurrent ABPM were performed for up to 5 years on 3448 subjects (mean age 44.6 years) who gave consent for follow-up. Subjects with hypertension were told to consult their family doctor so that they could receive antihypertensive treatment (the angiotensin receptor blocker eprosartan, an ACE-inhibitor or a beta-blocker were recommended for initial treatment). Subjects were classified as being in mental strain (stress-positive [stress+]/ stress-negative [stress-]), using standardized questionnaires.
RESULTS: Only 1242 (36.0%) of the 3448 employees (69.% males) were normotensives. Only 166 (7.5%) of the 2206 hypertensives had normal ABPMs (<135/85 mmHg) and received antihypertensive treatment at the time of inclusion into the trial. During follow-up 57.8% of patients were treated with eprosartan or ACE-inhibitors, 34.6% with beta-blockers. By the time of the final visit 80.5% of hypertensives had achieved improvement of systolic and/or diastolic blood pressures (29.1% normotensive). Patients with hypertensive ABPM at baseline had more cardiovascular events than normotensives (normotensives 3.0%; grade 1 7.8%, grade 2-3 9.8%). Hypertensive ABPMs at the last follow up or an increase in blood pressure grade were associated with higher event rates than normotensives (stable normotensives 1.8% events vs. stable hypertensives 7.9%, vs. worsening or grade 2-3: 9.1%) More hypertensives were classified as stress+ than normotensives. Persons classified as stress- (or changing to stress-) had fewer events (6.2%) than those regarded as stress+ or changing to stress+ (7.1%). Persons regarded as stable stress- had lower mean blood pressures than those who were stable stress+. Change to another stress group was associated with an increase or decrease of mean blood pressure.
CONCLUSIONS: Many employed people are hypertensive at work and are not treated adequately. ABPM control and antihypertensive treatment based on eprosartan, ACE-inhibitors or beta-blockers resulted in a significant increase in the number of patients with lower blood-pressure levels and a reduction in cardiovascular events. Patients under mental strain were more likely to be hypertensive. Mental strain was associated with changes in blood pressure.
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
2006 |
|---|---|
| Erschienen: |
2006 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:131 |
|---|---|
| Enthalten in: |
Deutsche medizinische Wochenschrift (1946) - 131(2006), 46 vom: 17. Nov., Seite 2580-5 |
| Sprache: |
Deutsch |
|---|
| Weiterer Titel: |
Stressassoziierte Hypertonie am Arbeitsplatz--Ergebnisse des STARLET-Projekts |
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| Beteiligte Personen: |
Lüders, S [VerfasserIn] |
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| Anmerkungen: |
Date Completed 11.12.2006 Date Revised 20.11.2014 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM166506060 |
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| 100 | 1 | |a Lüders, S |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Stress-associated hypertension in the work place |b results of the STARLET project |
| 246 | 3 | 3 | |a Stressassoziierte Hypertonie am Arbeitsplatz--Ergebnisse des STARLET-Projekts |
| 264 | 1 | |c 2006 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
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| 500 | |a Date Completed 11.12.2006 | ||
| 500 | |a Date Revised 20.11.2014 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND AND OBJECTIVE: To assess the influence of work stress and initial blood pressure on the prognosis of hypertension | ||
| 520 | |a SUBJECTS AND METHODS: In a prospective, controlled, multicentre, observational study, ambulatory 24-hour blood pressure measurements (ABPM) of employees from different work places were recorded at the work place on working days. Recurrent ABPM were performed for up to 5 years on 3448 subjects (mean age 44.6 years) who gave consent for follow-up. Subjects with hypertension were told to consult their family doctor so that they could receive antihypertensive treatment (the angiotensin receptor blocker eprosartan, an ACE-inhibitor or a beta-blocker were recommended for initial treatment). Subjects were classified as being in mental strain (stress-positive [stress+]/ stress-negative [stress-]), using standardized questionnaires | ||
| 520 | |a RESULTS: Only 1242 (36.0%) of the 3448 employees (69.% males) were normotensives. Only 166 (7.5%) of the 2206 hypertensives had normal ABPMs (<135/85 mmHg) and received antihypertensive treatment at the time of inclusion into the trial. During follow-up 57.8% of patients were treated with eprosartan or ACE-inhibitors, 34.6% with beta-blockers. By the time of the final visit 80.5% of hypertensives had achieved improvement of systolic and/or diastolic blood pressures (29.1% normotensive). Patients with hypertensive ABPM at baseline had more cardiovascular events than normotensives (normotensives 3.0%; grade 1 7.8%, grade 2-3 9.8%). Hypertensive ABPMs at the last follow up or an increase in blood pressure grade were associated with higher event rates than normotensives (stable normotensives 1.8% events vs. stable hypertensives 7.9%, vs. worsening or grade 2-3: 9.1%) More hypertensives were classified as stress+ than normotensives. Persons classified as stress- (or changing to stress-) had fewer events (6.2%) than those regarded as stress+ or changing to stress+ (7.1%). Persons regarded as stable stress- had lower mean blood pressures than those who were stable stress+. Change to another stress group was associated with an increase or decrease of mean blood pressure | ||
| 520 | |a CONCLUSIONS: Many employed people are hypertensive at work and are not treated adequately. ABPM control and antihypertensive treatment based on eprosartan, ACE-inhibitors or beta-blockers resulted in a significant increase in the number of patients with lower blood-pressure levels and a reduction in cardiovascular events. Patients under mental strain were more likely to be hypertensive. Mental strain was associated with changes in blood pressure | ||
| 650 | 4 | |a English Abstract | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 7 | |a Acrylates |2 NLM | |
| 650 | 7 | |a Adrenergic beta-Antagonists |2 NLM | |
| 650 | 7 | |a Angiotensin II Type 1 Receptor Blockers |2 NLM | |
| 650 | 7 | |a Angiotensin-Converting Enzyme Inhibitors |2 NLM | |
| 650 | 7 | |a Antihypertensive Agents |2 NLM | |
| 650 | 7 | |a Imidazoles |2 NLM | |
| 650 | 7 | |a Thiophenes |2 NLM | |
| 650 | 7 | |a eprosartan |2 NLM | |
| 650 | 7 | |a 2KH13Z0S0Y |2 NLM | |
| 700 | 1 | |a Hammersen, F |e verfasserin |4 aut | |
| 700 | 1 | |a Kulschewski, A |e verfasserin |4 aut | |
| 700 | 1 | |a Frerichs, A |e verfasserin |4 aut | |
| 700 | 1 | |a Frieg, R |e verfasserin |4 aut | |
| 700 | 1 | |a Hahnheiser, D |e verfasserin |4 aut | |
| 700 | 1 | |a Reich, G |e verfasserin |4 aut | |
| 700 | 1 | |a Schnieders, M |e verfasserin |4 aut | |
| 700 | 1 | |a Schrandt, G |e verfasserin |4 aut | |
| 700 | 1 | |a Schrader, J |e verfasserin |4 aut | |
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