| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
ORIGINAL ARTICLES |
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; Department of Psychology, Free University (G.W.), Amsterdam, Netherlands; and Institute of Experimental Psychology II, University of Düsseldorf (C.K.), Düsseldorf, Germany.
Address reprint requests to: Andrew Steptoe, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom. Email: a.steptoe{at}ucl.ac.uk
OBJECTIVES: The influence of low socioeconomic status on cardiovascular disease may be mediated in part by sustained activation of stress-related autonomic and neuroendocrine processes. We hypothesized that low socioeconomic status would be associated with heightened ambulatory blood pressure and cortisol output over the working day.
METHODS: One hundred eight men and 94 women from the Whitehall II epidemiological cohort participated. Blood pressure and heart rate were monitored every 20 minutes over a working day and evening, and salivary cortisol was sampled on waking up and at 2-hour intervals. Measures were also taken under resting laboratory conditions. Socioeconomic status was indexed by grade of employment.
RESULTS: Resting blood pressure, heart rate, and cortisol did not differ by grade. Ambulatory systolic pressure was greater in the morning in the lower (128.9 ± 15.7 mm Hg) than the intermediate (122.6 ± 12.5 mm Hg) and higher grades (123.3 ± 12.7 mm Hg) after adjustment for age, sex, smoking, and alcohol intake (p = .019). Heart rate was also raised in the morning in the lower grade participants. Differences in morning systolic pressure and heart rate were independent of concurrent physical activity. Cortisol concentration was greater in lower than higher grade men (9.54 ± 4.1 vs. 7.38 ± 2.8 nmol/liter, p = .008) but was more elevated in higher than lower grade women (7.84 ± 2.5 vs. 6.35 ± 1.9 nmol/liter, p = .014). Differences remained significant after adjustment for age, time of awakening, smoking, and alcohol intake.
CONCLUSIONS: Socioeconomic differences in blood pressure and cortisol may reflect stress-related activation of biological pathways that contribute to variations in disease risk.
Key Words: socioeconomic status, • blood pressure, • cortisol, • ambulatory monitoring, • stress, • coronary heart disease.
Abbreviations: BP = blood pressure;; CHD = coronary heart disease;; HR = heart rate;; SES = socioeconomic status.
This article has been cited by other articles:
 |
|
 |
|
  A. Steptoe, K. O'Donnell, E. Badrick, M. Kumari, and M. Marmot Neuroendocrine and Inflammatory Factors Associated with Positive Affect in Healthy Men and Women: The Whitehall II Study Am. J. Epidemiol., January 1, 2008; 167(1): 96 - 102. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. B. Dowd, M. N. Haan, L. Blythe, K. Moore, and A. E. Aiello Socioeconomic Gradients in Immune Response to Latent Infection Am. J. Epidemiol., January 1, 2008; 167(1): 112 - 120. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Kneipp, D. P. Welch, C. E. Wood, C. B. Yucha, and H. Yarandi Psychosocial and Physiological Stress Among Women Leaving Welfare West J Nurs Res, November 1, 2007; 29(7): 864 - 883. [Abstract] [PDF]
|
|
|
|
 |
|
 P. J. Gianaros, J. A. Horenstein, S. Cohen, K. A. Matthews, S. M. Brown, J. D. Flory, H. D. Critchley, S. B. Manuck, and A. R. Hariri Perigenual anterior cingulate morphology covaries with perceived social standing Soc Cogn Affect Neurosci, September 1, 2007; 2(3): 161 - 173. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. L. Mangold, R. Veraza, L. Kinkler, and N. A. Kinney Neuroticism Predicts Acculturative Stress in Mexican American College Students Hispanic Journal of Behavioral Sciences, August 1, 2007; 29(3): 366 - 383. [Abstract] [PDF]
|
|
|
|
|
|
C. H. Kroenke, D. Spiegelman, J. Manson, E. S. Schernhammer, G. A. Colditz, and I. Kawachi Work Characteristics and Incidence of Type 2 Diabetes in Women Am. J. Epidemiol., January 15, 2007; 165(2): 175 - 183. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. M. Kittleson, L. A. Meoni, N.-Y. Wang, A. Y. Chu, D. E. Ford, and M. J. Klag Association of Childhood Socioeconomic Status With Subsequent Coronary Heart Disease in Physicians Arch Intern Med, November 27, 2006; 166(21): 2356 - 2361. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. B Dowd and N. Goldman Do biomarkers of stress mediate the relation between socioeconomic status and health? J. Epidemiol. Community Health, July 1, 2006; 60(7): 633 - 639. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Zorawski, N. Q. Blanding, C. M. Kuhn, and K. S. LaBar Effects of stress and sex on acquisition and consolidation of human fear conditioning Learn. Mem., July 1, 2006; 13(4): 441 - 450. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Cohen, W. J. Doyle, and A. Baum Socioeconomic Status Is Associated With Stress Hormones Psychosom Med, May 1, 2006; 68(3): 414 - 420. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Cohen, J. E. Schwartz, E. Epel, C. Kirschbaum, S. Sidney, and T. Seeman Socioeconomic Status, Race, and Diurnal Cortisol Decline in the Coronary Artery Risk Development in Young Adults (CARDIA) Study Psychosom Med, January 1, 2006; 68(1): 41 - 50. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Ranjit, E. A Young, and G. A Kaplan Material hardship alters the diurnal rhythm of salivary cortisol Int. J. Epidemiol., October 1, 2005; 34(5): 1138 - 1143. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. L. Szanton, J. M. Gill, and J. K. Allen Allostatic Load: A Mechanism of Socioeconomic Health Disparities? Biol Res Nurs, July 1, 2005; 7(1): 7 - 15. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Steptoe, J. Wardle, and M. Marmot Positive affect and health-related neuroendocrine, cardiovascular, and inflammatory processes PNAS, May 3, 2005; 102(18): 6508 - 6512. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Rozanski and L. D. Kubzansky Psychologic Functioning and Physical Health: A Paradigm of Flexibility Psychosom Med, May 1, 2005; 67(Supplement_1): S47 - S53. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Steptoe, L. Brydon, and S. Kunz-Ebrecht Changes in Financial Strain Over Three Years, Ambulatory Blood Pressure, and Cortisol Responses to Awakening Psychosom Med, March 1, 2005; 67(2): 281 - 287. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Steptoe, J. Siegrist, C. Kirschbaum, and M. Marmot Effort--Reward Imbalance, Overcommitment, and Measures of Cortisol and Blood Pressure Over the Working Day Psychosom Med, May 1, 2004; 66(3): 323 - 329. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
