Journal of Public Health Medicine 25:62-68 (2003)
© 2003 Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom
Self-reported stress and subsequent hospital admissions as a result of hypertension, varicose veins and haemorrhoids
Chris Metcalfe
George Davey Smith
John Macleod
Pauline Heslop
Carole Hart
MRC Biostatistics Unit, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR.
Department of Social Medicine, University of Bristol, Bristol BS8 2PR.
Department of Primary Care and General Practice, University of Birmingham, Birmingham B15 2TT.
Public Health and Health Policy, Division of Community Based Sciences, University of Glasgow, Glasgow G12 8RZ.
Address correspondence to Chris Metcalfe. E-mail: chris.metcalfe@mrc-bsu.cam.ac.uk
Background This study examines a cohort in which individuals of privileged socio-economic position report greater psychological stress. We have previously shown in this cohort that stress is unrelated to coronary heart disease as measured by hospital discharge diagnosis and cause-specific death. In contrast, stress and hospitalization for cardiovascular conditions not requiring mandatory admission were associated. We hypothesized that psychosocial factors, in particular reporting tendency, are the likely mediator of this association, and the present study considers this further.
Methods A total of 5596 men underwent a health screening during which they completed the Reeder Stress Inventory. Details of hospital admissions were retrieved from the Scottish Morbidity Records over a 21 year follow-up. Relationships between stress and admission were evaluated using proportional hazards regression.
Results Compared with low stress, reported high stress was found to be associated with increased numbers of admissions for each of three most common cardiovascular causes of non-mandatory admission: adjusted hazard ratios were 3.43 for essential hypertension (95 per cent confidence interval (CI) 1.36–8.65), 1.91 for lower limb varicose veins (95 per cent CI 1.12–3.24), and 2.01 for haemorrhoids (95 per cent CI 1.16–3.51). Stress and blood pressure at baseline were not associated.
Conclusion The association between stress and admissions as a result of hypertension appears unlikely to be mediated by blood pressure. More likely is a mechanism based upon the reporting of symptoms, or the recording of discharge diagnoses. There is no obvious medical explanation for associations between stress and hospitalization as a result of varicose veins or haemorrhoids, and again it is likely that psychosocial factors provide the mechanism.
Keywords: psychosocial factors, stress, hospital admission, cardiovascular disease
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  B Ohlin, P.M Nilsson, J-A Nilsson, and G Berglund Chronic psychosocial stress predicts long-term cardiovascular morbidity and mortality in middle-aged men Eur. Heart J., May 2, 2004; 25(10): 867 - 873. [Abstract] [Full Text] [PDF]
|
|