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The Effects of Effort-Reward Imbalance on Inflammatory and Cardiovascular Responses to Mental Stress

From the Psychobiology Group, Department of Epidemiology and Public Health, University College London, UK (M.H., E.W., P.G., A.S.); Institute of Cancer Research, Royal Marsden Hospital, London, UK (R.V.); School of Human and Life Sciences, Roehampton University, Surrey, UK (E.L.G.).

Address correspondence and reprint requests to Mark Hamer, PhD, Psychobiology Group, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK. E-mail: m.hamer{at}ucl.ac.uk

Objective: We examined the influence of effort-reward imbalance, a stressful feature of the work environment, on cardiovascular and inflammatory responses to acute mental stress.

Methods: Ninety-two healthy men (mean age, 33.1 yeasr) in full-time employment were recruited. Effort-reward imbalance was measured using a self-administered questionnaire. Blood, for the analysis of C-reactive protein (CRP) and von Willebrand factor (vWF) antigen, was sampled at baseline and 10 minutes after two mental stress tasks, whereas cardiovascular activity was measured throughout.

Results: Plasma CRP and vWF were significantly elevated following the stress period, and cardiovascular activity was increased during and after both tasks (p < .001). Multiple linear regression analysis adjusted for age, body mass index, and baseline levels revealed that men with higher effort-reward imbalance demonstrated greater CRP and vWF responses to the stress tasks but blunted cardiovascular responses. Inflammatory and cardiovascular responses to stress appeared to be unrelated.

Conclusions: These findings suggest that the association between chronic work stress and cardiovascular disease risk may be mediated in part by heightened acute inflammatory responsivity. These responses appear not to result from differences in sympathoadrenal activation.

Key Words: inflammatory response • acute mental stress • chronic work stress • C-reactive protein • Von Willebrand factor • cardiovascular disease risk

Abbreviations: ERI = effort-reward imbalance; CHD = coronary heart disease; IL = interleukin; CRP = C-reactive protein; vWF = von Willebrand factor; BMI = body mass index.

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