This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Steptoe, A. Articles by Marmot, M. Search for Related Content PubMed PubMed Citation Articles by Steptoe, A. Articles by Marmot, M. Related Collections Blood Pressure Neuroendocrine Depression Sexual Medicine: Female Sexual Medicine: Male Stress and Coping

Effort—Reward Imbalance, Overcommitment, and Measures of Cortisol and Blood Pressure Over the Working Day

From the Department of Epidemiology and Public Health, University College London, UK (A.S., M.M.); Institute of Medical Sociology, University of Dusseldorf, Germany (J.S.); and Department of Experimental Psychology, Technical University of Dresden, Germany (C.K.).

Address correspondence and reprint requests to Andrew Steptoe, Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK. E-mail: a.steptoe{at}ucl.ac.uk

OBJECTIVE: To assess the biological correlates of effort—reward imbalance and overcommitment to work using measurements over the working day.

METHODS: Participants were 197 working men and women aged 45 to 59 years, recruited from the Whitehall II epidemiological cohort. Salivary cortisol was sampled on waking, 30 minutes later, and then at 2-hour intervals from 8:00 hours to 22:00 hours. Blood pressure was measured every 20 minutes using ambulatory methods. Effort–reward imbalance and overcommitment to work were assessed with standard questionnaires.

RESULTS: Cortisol responses to waking were positively associated with overcommitment in men, with mean increases between waking and 30 minutes of 14.5 and 4.2 nmol/l in high and low overcommitment groups, after adjustment for age, socioeconomic position, smoking, time of waking up, and job demands. Cortisol averaged from 8 samples over the working day was also related to overcommitment in men, with an average difference of 22% between high and lower overcommitment groups. Overcommitment predicted systolic blood pressure over the day in men after adjustment for age, smoking, body mass index, physical activity, and job control, with adjusted means of 132.2 and 125.8 mm Hg in high and low overcommitment groups. There was a significant interaction between overcommitment, socioeconomic position, and time of day in men (p = .016), because systolic pressure was higher in lower status overcommitted men, and rose over the day. Neither effort—reward imbalance nor overcommitment predicted biological responses in women.

CONCLUSIONS: Chronic neuroendocrine and cardiovascular activation may mediate in part the impact of overcommitment to work on cardiovascular disease risk in men.

Key Words: work stress, • overcommitment, • effort—reward imbalance, • cortisol, • ambulatory blood pressure, • socioeconomic position, • cardiovascular disease risk.

Abbreviations: CHD = coronary heart disease.

This article has been cited by other articles:

				G. Sorensen, A. M. Stoddard, T. Dubowitz, E. M. Barbeau, J. Bigby, K. M. Emmons, L. F. Berkman, and K. E. Peterson The Influence of Social Context on Changes in Fruit and Vegetable Consumption: Results of the Healthy Directions Studies Am J Public Health, July 1, 2007; 97(7): 1216 - 1227. [Abstract] [Full Text] [PDF]

				Y. J. Zanstra, J. M. H. Schellekens, C. Schaap, and L. Kooistra Vagal and Sympathetic Activity in Burnouts During a Mentally Demanding Workday Psychosom Med, July 1, 2006; 68(4): 583 - 590. [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]