Coping with unfair treatment at work - What is the relationship between coping and hypertension in middle-aged men and women? An epidemiological study of working men and women in Stockholm (the WOLF study)

Background: An important hypothesis in psychosomatic medicine is that expos ure to psychosocial factors that arouse anger may accelerate the onset of h ypertension, particularly if the subject is not allowed to show anger or to deal constructively with the factor that evoked it. For working men and wo men, being treated in an unfair way at work may be crucial. The present stu dy was designed to answer the question whether the pattern of coping primar ily directed towards the aggressor (open) or directed inwards or towards ot hers (covert) - is associated with hypertension among working men and women . Study group: Five thousand seven hundred and twenty working men and women a ged 15-64 participated in the study. The participation rate was 76%. Methods: The coping pattern was studied by means of a Swedish version of a self-administered questionnaire that was originally introduced by Harburg e t al. Results: Significant results were confined to the age group 45-54. All anal yses were adjusted for age and body mass index. Smoking habits and social c lass had no effect on the relationships. Low scores (lowest quartile) for o pen coping tended to be associated with an elevated prevalence ratio (PR) o f hypertension both among men (PR 1.3, 95% confidence interval, CI, 0.9-1.7 ) and women (PR 1.4, 95% CI 1.0-2.0). High scores for covert coping (highes t quartile) were associated with an elevated PR of hypertension among men ( PR 1.6, 95% CI 1.2-2.2) but not in women. If the analysis was confined to c ases without medication, the relationship between a high level of covert co ping and high blood pressure was still significant for men. For women, howe ver, no significant findings were made after this operation. Accordingly, t he relationship between a tow level of open coping and hypertension in wome n was confined to women with medication. Coping patterns were correlated wi th psychosocial work environment factors, in particular decision latitude. Conclusion: In men, covert coping was associated with prevalence of hyperte nsion. In women, there tended to be a relationship between low scores for o pen coping and hypertension. Copyright (C) 2000 S. Karger AG, Basel.