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Overcommitment to Work Is Associated With Changes in Cardiac Sympathetic Regulation

From the Department of Social Medicine / Public Health and Epidemiology, Academic Medical Centre, Amsterdam, The Netherlands (T.G.M.V.); Department of Health Psychology, Utrecht University, The Netherlands (L.J.P.D.); Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands (E.J.C.G.).

Address correspondence and reprint requests to Tanja G. M. Vrijkotte, Department Public Health and Epidemiology, Academic Medical Centre, Postbox 22700, 1100 DE Amsterdam, The Netherlands. E-mail: t.vrijkotte{at}amc.uva.nl

OBJECTIVE: Work stress is associated with an increased risk for cardiovascular disease (CVD). Exaggerated cardiovascular reactivity to work-related stressors or incomplete recovery after work is a proposed mechanism underlying this increase in risk. This study examined the effects of work stress on 24-hour profiles of the pre-ejection period (PEP), a measure of cardiac sympathetic activity, obtained from ambulatory measurement of the impedance cardiogram.

METHODS: A total of 67 male white-collar workers (age 47.1 ± 5.2) underwent ambulatory monitoring on 2 workdays and 1 non-workday. Work stress was defined according to Siegrist’s model as 1) a combination of high effort and low reward at work (high imbalance) or 2) an exhaustive work-related coping style (high overcommitment).

RESULTS: High overcommitment was associated with shorter absolute PEP levels during all periods on all 3 measurement days, reduced wake-to-sleep PEP differences and reduced PEP variability, as indexed by the SD.

CONCLUSIONS: Overcommitment to work was associated with an increase in basal sympathetic drive and a reduction in the dynamic range of cardiac sympathetic regulation. Both findings are compatible with the hypothesis that overcommitment induces ß-receptor down-regulation.

Key Words: ambulatory impedance cardiogram • pre-ejection period • work stress • ionotropic cardiac regulation

Abbreviations: BP = blood pressure;; BMI = body mass index;; CVD = cardiovascular disease;; ERI = effort-reward imbalance;; HR = heart rate;; ICG = impedance cardiograms;; MANOVA = multivariate analysis of variance;; PAI-1 = plasminogen activator inhibitor;; PEP = pre-ejection period;; SDPEP = SD pre-ejection period;; VU-AMS = Vrije Universiteit Ambulatory Monitoring System;; WHR = waist to hip ratio.

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