Neuroendocrine Findings in Anxiety Disorders

Increases in job strain are associated with incident hypertension in the CARDIA Study

BACKGROUND

Job strain, defined as high job demands and low decision latitude, has been associated with increased blood pressure levels in some studies, but most of these studies have been cross-sectional.

PURPOSE

We sought to determine whether changes in job strain during young adulthood were associated with the development of hypertension, using the Coronary Artery Risk Development in Young Adults cohort.

METHODS

A total of 3,200 employed, initially normotensive participants, aged 20 to 32 in 1987-1988, were followed for 8 years; the Job Content Questionnaire was completed twice: initially and 8 years later. Hypertension at follow-up was defined as systolic blood pressure (SBP) of 160 or higher and diastolic blood pressure of 95 mmHg or higher, or reporting being on antihypertensive medication.

RESULTS

Job strain (based on job demands above the median and decision latitude below the median of the sample) was associated with hypertension incidence (ps <.05) for the entire cohort and among White women and men. Adjustment for baseline SBP, education, body mass index (BMI), change in BMI, and age did not alter these relations. The ratio of increasing demands relative to decreasing decision latitude was also associated with greater incidence of hypertension in the entire cohort in the multivariate model (odds ratio = 2.06, 95% confidence interval = 1.01-4.26).

CONCLUSIONS

An increase in job strain is associated with incident hypertension, particularly among Whites.

Adrenergic status in anxiety disorders: platelet alpha 2-adrenergic receptor binding, blood pressure, pulse, and plasma catecholamines in panic and generalized anxiety disorder patients and in normal subjects

In order to evaluate adrenergic function in anxiety disorders, platelet alpha 2-adrenergic binding parameters and supine and standing blood pressure, pulse, and venous plasma epinephrine and norepinephrine were determined in patients with panic attacks or generalized anxiety disorder and in normal subjects. The maximum number of binding sites (Bmax) for the partial agonist tritiated clonidine was significantly lower for both patient groups than for normal subjects, and the Bmax for the antagonist tritiated yohimbine was significantly lower for panic patients. There were no other substantive differences across groups. Prior exposure to psychotropic drugs might account for the results for clonidine binding, but not for yohimbine. The Bmax for clonidine was correlated with norepinephrine increases upon standing and, for panic patients, with the severity of full unexpected panic attacks. These data provide further evidence of adrenergic receptor abnormalities in people with anxiety disorders.