Job strain and ambulatory blood pressure in British general practitioners: A preliminary study

Abstract

Occupational stress, in particular 'high strain' (defined as high psychological job demands and low job control; Karasek, 1979) has been found to be associated with coronary heart disease and hypertensive risk in a number of occupations. However, despite the large number of studies of GP stress, none have extended this model to British GPs. It was hypothesized that 'high strain' GPs would exhibit heightened levels of cardiovascular arousal compared to 'low strain' GPs, with a carry-over effect into the non-work day. Twenty low strain GPs were compared with seven high strain GPs on ambulatory blood pressure during a work day, work day evening, non-work day and non-work day evening. Work day and non-work day monitoring was counterbalanced. Levels of mental health and job satisfaction were also assessed. High strain GPs' systolic blood pressure and diastolic blood pressure was generally elevated, in particular during the non-work day, compared to their low strain counterparts. No gender differences were found for any of the BP variables. Levels of depression, anxiety and job dissatisfaction were found to be significantly greater for high strain GPs. In terms of GP stress research, these findings are novel; however replication is required with a larger sample.