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From the Department of Epidemiology and Public Health, University College London (A.S., S.K-E., N.O., P.J.F., M.M.), London, United Kingdom; and the Haemostasis, Thrombosis, and Vascular Medicine Unit, University Department of Medicine (A.R., G.D.O.L.), Glasgow, United Kingdom.
Address reprint requests to: Dr. Andrew Steptoe, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK. Email: a.steptoe{at}ucl.ac.uk
OBJECTIVE: An elevation in plasma fibrinogen may be one of the pathways through which low socioeconomic status increases cardiovascular disease risk. This study assessed the influence of socioeconomic status, job control, and social isolation on fibrinogen responses to acute stress.
METHODS: The study was conducted with 125 white men and 96 white women aged 47 to 58 years, drawn from the Whitehall II cohort. Socioeconomic status was indexed by grade of employment, with 82 high, 75 intermediate, and 64 low grade participants. Plasma fibrinogen and hematocrit were assessed at baseline, immediately after performance of color-word and mirror tracing tasks, and 45 minutes later.
RESULTS: Plasma fibrinogen increased from baseline to stress (from 2.85 ± 0.57 to 2.92 ± 0.58 g/liter), remaining elevated 45 minutes after stress (2.89 ± 0.58 g/liter, p < .001). Fibrinogen concentration was greater in the low than in the high or intermediate employment grade groups, independently of sex, age, body mass index, smoking status, and hematocrit. Fibrinogen responses to acute stress did not differ across employment grades. Women had higher fibrinogen levels than men, but this pattern was abolished in women taking hormone replacement therapy. Men experiencing low job control showed greater fibrinogen responses to acute stress than did those with high job control (p = .003). Fibrinogen levels were greater in socially isolated individuals, but social isolation did not affect responses to acute stress.
CONCLUSIONS: Socioeconomic status and acute stress had independent effects on the plasma fibrinogen level. Low job control may influence cardiovascular disease risk in men partly through provoking greater fibrinogen stress responses.
Key Words: fibrinogen • socioeconomic status • job control • stress • social isolation.
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