The influence of abdominal obesity and chronic work stress on ambulatory blood pressure in men and women.

OBJECTIVE: To assess the influence of abdominal obesity and work stress (operationalised as low control over work) on ambulatory blood pressure on a working day and evening. PARTICIPANTS AND METHODS: 156 school teachers (58 men and 98 women) carried out ambulatory blood pressure and heart rate monitoring on a work day and evening. Cardiovascular activity was also measured under baseline conditions on another occasion, when body weight, height, waist and hip circumference were assessed. Perceived control over work was assessed by questionnaire, along with mental health, anger expression and social support. 126 participants repeated the protocol after 12 months. Waist/hip ratio was used as the index of abdominal obesity. RESULTS: Baseline blood pressure was positively associated with waist/hip ratio in men, but ambulatory blood pressure and heart rate were not independently related to waist/hip ratio or job control. However, blood pressure and heart rate recorded during the working day and evening were elevated in men with high waist/hip ratio who experienced low job control, independently of age and body weight. Effects for diastolic blood pressure and heart rate were replicated after 12 months. Body mass index was not related to blood pressure or heart rate during the day or evening after adjustment for age and waist circumference. Low job control was associated with poor psychological well-being, negative mood and lack of social support. CONCLUSIONS: The results are consistent with the hypothesis that abdominal obesity in men is characterised by a tendency towards heightened stress-induced physiological activation, but that this tendency will only be manifest in the presence of appropriate environmental challenges such as chronic work stress