Document Detail

Changes in financial strain over three years, ambulatory blood pressure, and cortisol responses to awakening.
MedLine Citation:
PMID:  15784795     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Chronic psychosocial stress has been associated cross-sectionally with ambulatory blood pressure and with salivary cortisol, but there have been few longitudinal studies of the effects of changes in chronic stress. We assessed the influence of changes in financial strain on ambulatory blood pressure and salivary cortisol. METHODS: Data were analyzed from 160 men and women age 47 to 59 years at the first assessment (T1) who repeated ambulatory monitoring 3 years later (T2). We analyzed change in financial strain as a continuous variable, and specifically compared people who did and did not report an improvement in financial strain. RESULTS: Change in financial strain was associated with change in ambulatory systolic pressure after controlling for T1 ambulatory systolic pressure, gender, socioeconomic position, age, smoking, body mass index, and T1 financial strain (p = .041). Systolic pressure at T2 was lower in the improved financial strain (121.7 +/- 11.2 mm Hg) than in the worse/no change group (125.5 +/- 11.5 mm Hg; p = .029). The corresponding diastolic pressures averaged 78.5 +/- 7.1 mm Hg and 80.7 +/- 7.9 mm Hg, respectively (p = .061). The cortisol awakening response (difference between waking and 30 minutes later) was lower (p = .048) in men who reported improved financial strain, controlling for T1 cortisol response, socioeconomic position, age, smoking, time of waking, and T1 financial strain. There were no differences in the slope of cortisol decline over the day or in evening values. CONCLUSION: These longitudinal data extend cross-sectional findings in showing associations between favorable changes in chronic stress and reduced cardiovascular and neuroendocrine activation in everyday life.
Andrew Steptoe; Lena Brydon; Sabine Kunz-Ebrecht
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Psychosomatic medicine     Volume:  67     ISSN:  1534-7796     ISO Abbreviation:  Psychosom Med     Publication Date:    2005 Mar-Apr
Date Detail:
Created Date:  2005-03-23     Completed Date:  2006-06-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376505     Medline TA:  Psychosom Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  281-7     Citation Subset:  IM    
Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom.
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MeSH Terms
Age Factors
Blood Pressure / physiology
Blood Pressure Monitoring, Ambulatory
Circadian Rhythm / physiology
Hydrocortisone / analysis*
Hypertension / diagnosis*,  psychology
Income / statistics & numerical data*
Longitudinal Studies
Middle Aged
Saliva / chemistry*
Sex Factors
Socioeconomic Factors*
Stress, Psychological / diagnosis,  psychology*
Reg. No./Substance:

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