Work Stress and Metabolic and Hemostatic Risk Factors

Objective: A high level of work stress has been associated with cardiovascular disease. However, the pathophysi-ological 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. He-mostatic 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 overcommit-ment (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. Key words: fibrinolysis, insulin resistance syndrome, chronic stress, overcommitment. BMI 5 body mass index; HDL 5 high-density lipopro-tein; IRS 5 insulin resistance syndrome; LDL 5 low-density lipoprotein; PAI-1 5 type 1 plasminogen acti-vator inhibitor; TC 5 total cholesterol; TG 5 triglyceride; tPA 5 tissue-type plasminogen activator