Study: Working stress and dyslipidemia

Reference

Catalina-Romero C, Calvo e, Sánchez-Chaparro Ma, et al. The connection between working stress and dyslipidemia. Scand J public Health . 2013; 41 (2): 142-149.

Design

observing cross -sectional analysis as a supplement to the insurance -based cohort study Ibermutuamur Cardiocular risk assessment (ICARIA).

participant

73,332 working employees of insurance companies in Spain aged 18 to 60 years took part in the study. About 70 % of the sample were male. A total of 6,239 (8.5 %) reported on professional stress in the sense of the Interheart study.

study parameters

Working stress, total cholesterol, LDL-C, HDL-C, triglyceride, age, gender, smoking status, alcohol consumption, obesity, professional level, physical leisure activity and application of a lipid-reducing therapy

primary result dimensions

bivariate and multivariable relationships between working stress and lipid values (e.g. total cholesterol, LDL-C, HDL-C, triglyceride)

most important knowledge

Working stress was significantly associated with the female gender, the age, the level of education, an “employee position” and dyslipidemia, including earlier or current diagnosis of dyslipaemia, a lipid-lowering therapy and/or a high overall cholesterol and LDL value and low HDL-C.

The multivariate adaptation for age, gender, smoking status, alcohol consumption, obesity, professional level and physical activity did not reduce the relationships between dyslipidemia and working stress.

effects on practice

This analysis of Catalina-Romero et al 2 offers the clinic an important memory of the contribution of psychosocial stress, including professional stress, to cardiovascular risk. Their results confirm the earlier results of the Fall Control study Interheart, in which it was found that stress at the workplace is responsible for 8 % of the population risk for a first myocardial infarction (MI). Based. 4 Data were combined from 30 different European studies at an individual level and a total of 197,473 participants, 15 % of whom reported on professional stress. It was found that the professional burden is a significant independent risk factor for coronary diseases and contributes to a population -related risk (par) of 3.4 %.

In addition to stress in the workplace, other areas of psychosocial stress are also associated with the risk of cardiovascular events. In the Interheart study 1.3 low control, financial stress, serious stress in the past (e.g. business failure, depression and chronic stress at work or at home), all were associated with increased MI risk and accounted for 16 %, 11 %, 10 %, 9 %. or 8 % of the par for the first Wed. Taken together, these factors contributed 32.5 % to par for the first myocardial infarction.

In order to be able to provide for patients with a risk of cardiovascular diseases (these are all) comprehensively, psychosocial stress factors should be recorded and ideally quantified. Of course, it is crucial to build a safe therapeutic relationship in which patients are able to speak openly about their stress of life and the influence that he has on their health behavior. Clinical questionnaires (i.e. "screener" like the patient Health Questionnaire). ^{5.6 and the GAD-7 6 ) offer fast screening tools for depression or anxiety. Other areas of psychosocial health can be assessed by a detailed patient history or by the inclusion of additional questionnaires in a clinical admission (e.g. one that includes the control location). The use of instruments such as the questionnaire on patient health can help to facilitate advice, cognitive behavioral therapy or other interventions and can be used in the long term to ensure therapeutic progress. In my clinic we offer comprehensive integrative care of cardiovascular diseases and have newly created the interheart index for psychosocial stress and included in our initial reception so that we can quickly quantify and approach critical psychosocial elements of the disease risk.}

Despite the adaptation for many potentially confusing variables such as physical activity, smoking, age and gender, it would also be interesting to see whether the adaptation for nutritional behavior and/or eating habits would have influenced the results of Catalina-Romero and colleagues. The inclusion of nutritional practices would probably have reduced the extent of the connections between workload and lipid -related risk, since psychosocial stress and workload were associated in particular with an increased absorption of energy -oriented foods and a lower absorption of fruit and vegetables. A higher self -efficacy and more social support than of crucial importance. In clinical practice, social support and information about healthy eating habits as well as the promotion of diet changes are possible. The available findings indicate that integrative practitioners such as naturopaths are able to improve behavior, including nutritional practices, in patients with increased risk of cardiovascular diseases. It is noteworthy that the structure of self -confidence to change behavior and the promotion of effectiveness in the workplace and at home for patients with professional stress and a very low level of control at work can be a challenge. Suppression at the workplace promotes the loss of self -confidence and fundamentally limits self -efficacy. However, not everyone can change the employer or position. This scenario requires additional support from the patient and often a specific cognitive behavioral training in order to again participate in the activities of everyday life and to promote activities in which the patient can keep a higher control. Since social support is an important indicator of increased consumption of fruit and vegetables, the establishment of a self-help group for cardiovascular diseases or a group chef course for Mediterranean diet is an entertaining and efficient way to provide education and social support and to increase self-efficacy in a single intervention.

The identification and treatment of psychosocial risk factors is necessary for the holistic treatment of cardiovascular diseases and the prevention of cardiovascular diseases. Like Catalina-Romero et al. have shown that nutrition and health education are important elements for risk reduction, but external factors such as workload also have a strong impact on the risk. In addition, many people also extend to behaviors outside the workplace and can have a direct impact on the risk of illness. Although it is increasingly important in the workplace to give employees access to healthier food, paradoxically, a more effective intervention in the workplace is to create a work environment in which the employees feel trustworthy and valuable and have freedom to fulfill their work tasks without oppression.