The perception of work stressors is related to reduced parasympathetic activity

  • Els Clays
  • Dirk De Bacquer
  • Vincent Crasset
  • France Kittel
  • Patrick de Smet
  • Marcel Kornitzer
  • Robert Karasek
  • Guy De Backer
Original Article



The aim was to examine the perception of work stressors in relation to ambulatory measures of heart rate variability (HRV).


Results are based on a sample of 653 healthy male workers aged 40–55 from the Belgian Physical Fitness Study conducted in 1976–1978. Data were collected by means of self-administered questionnaires and bio-clinical examinations. An index of physical and psychosocial work stressors containing five items was constructed based on the job stress questionnaire. Data on HRV were collected by means of 24-h ambulatory ECG recordings on a working day. Both time and frequency domain measures of HRV were calculated. Associations between work stressors and HRV measures were assessed by means of correlations, multiple linear regression analysis and analysis of (co)variance.


The work stressor index was significantly associated with lower pNN50 (the percentage of differences between adjacent normal RR intervals >50 ms), lower high frequency power and a higher ratio of low frequency over high frequency power. Very similar results were obtained after adjusting for age, language, occupation, smoking, body mass index, total cholesterol, systolic blood pressure and leisure time physical activity. No significant associations were found with SDNN (the standard deviation of all normal RR intervals) and low frequency power.


The perception of work stressors was related to reduced parasympathetic activity in a sample of 653 healthy male workers. These findings support the idea that particularly the parasympathetic component of the autonomic nervous system is related to work stress.


Work Stress Coronary heart disease Heart rate variability 


Conflict of interest

The authors declare that they have no conflict of interest.


  1. Belkic K, Landsbergis P, Schnall P, Baker D, Theorell T, Siegrist J, Peter R, Karasek R (2000) Psychosocial factors: review of the empirical data among men. Occup Med 15:24–46Google Scholar
  2. Belkic K, Landsbergis P, Schnall P, Baker D (2004) Is job strain a major source of cardiovascular disease risk? Scand J Work Environ Health 30:85–128Google Scholar
  3. Britton A, Hemingway H (2004) Heart rate variability in healthy populations: correlates and consequences. In: Malik M, Camm AJ (eds) Dynamic electrocardiography. Futura, Blackwell Publishing, New York, pp 90–111CrossRefGoogle Scholar
  4. Brotman DJ, Golden SH, Wittstein IS (2007) The cardiovascular toll of stress. Lancet 370:1089–1100CrossRefGoogle Scholar
  5. Chandola T, Britton A, Brunner E, Hemingway H, Malik M, Kumari M, Badrick E, Kivimaki M, Marmot M (2008) Work stress and coronary heart disease: what are the mechanisms? Eur Heart J 29:640–648CrossRefGoogle Scholar
  6. Chida Y, Steptoe A (2009) Cortisol awakening response and psychosocial factors: a systematic review and meta-analysis. Biol Psychol 80:265–278CrossRefGoogle Scholar
  7. Collins SM, Karasek RA, Costas K (2005) Job strain and autonomic indices of cardiovascular disease risk. Am J Ind Med 48:182–193CrossRefGoogle Scholar
  8. Dekker JM, Schouten EG, Klootwijk P, Pool J, Swenne CA, Kromhout D (1997) Heart rate variability from short electrocardiographic recordings predicts mortality from all causes in middle-aged and elderly men—The zutphen study. Am J Epidemiol 145:899–908Google Scholar
  9. Hall M, Vasko R, Buysse D, Ombao H, Chen QX, Cashmere JD, Kupfer D, Thayer JF (2004) Acute stress affects heart rate variability during sleep. Psychosom Med 66:56–62CrossRefGoogle Scholar
  10. Hemingway H, Marmot M (1999) Evidence based cardiology: psychosocial factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort studies. BMJ 318:1460–1467Google Scholar
  11. Hemingway H, Shipley M, Brunner E, Britton A, Malik M, Marmot M (2005) Does autonomic function link social position to coronary risk? The Whitehall II study. Circulation 111:3071–3077CrossRefGoogle Scholar
  12. Hintsanen M, Elovainio M, Puttonen S, Kivimäki M, Koskinen T, Raitakari O, Keltikangas-Järvinen L (2007) Effort-reward imbalance, heart rate, and heart rate variability: the cardiovascular risk in Young Finns Study. Int J Behav Med 14:202–212CrossRefGoogle Scholar
  13. Isowa T, Ohira H, Murashima S (2006) Immune, endocrine and cardiovascular responses to controllable and uncontrollable acute stress. Biol Psychol 71:202–213CrossRefGoogle Scholar
  14. Kageyama T, Nishikido N, Kobayashi T, Kurokawa Y, Kaneko T, Kabuto M (1998) Self-reported sleep quality, job stress, and daytime autonomic activities assessed in terms of short-term heart rate variability among male white-collar workers. Ind Health 36:263–272CrossRefGoogle Scholar
  15. Kang MG, Koh SB, Cha BS, Park JK, Woo JM, Chang SJ (2004) Association between job stress on heart rate variability and metabolic syndrome in shipyard male workers. Yonsei Med J 45:838–846Google Scholar
  16. Karasek R (2008) Low social control and physiological deregulation—the stress-disequilibrium theory, towards a new demand-control model. Scand J Work Environ Health Suppl 6:117–135Google Scholar
  17. Karasek R, Theorell T (1990) Healthy work. Stress, productivity, and the reconstruction of working life. Basic Books, New YorkGoogle Scholar
  18. Karasek R, Theorell T (2000) The demand-control-support model and CVD. Occup Med 15:78–83Google Scholar
  19. Kittel F, Kornitzer M, Dramaix M (1980) Coronary heart-disease and job stress in 2 cohorts of bank clerks. Psychother Psychosom 34:110–123CrossRefGoogle Scholar
  20. Kittel F, Kornitzer M, Debacker G, Dramaix M, Sobolski J, Degre S, Denolin H (1983) Type-A in relation to job-stress, social and bioclinical variables—the Belgian physical-fitness study. J Human Stress 9:37–45Google Scholar
  21. Kivimaki M, Virtanen M, Elovainio M, Kouvonen A, Vaananen A, Vahtera J (2006) Work stress in the etiology of coronary heart disease–a meta-analysis. Scand J Work Environ Health 32:431–442Google Scholar
  22. Kleiger RE, Miller JP, Bigger JT, Moss AJ (1987) Decreased heart-rate-variability and its association with increased mortality after acute myocardial-infarction. Am J Cardiol 59:256–262CrossRefGoogle Scholar
  23. Kornitzer M, de Smet P, Sans S, Dramaix M, Boulenguez C, De Backer G, Ferrario M, Houtman I, Isacsson SO, Ostergren PO, Peres I, Pelfrene E, Romon M, Rosengren A, Cesana G, Wilhelmsen M (2006) Job stress and major coronary events: results from the job stress, absenteeism and coronary heart disease in Europe study. Eur J Cardiovasc Prev Rehabil 13:695–704CrossRefGoogle Scholar
  24. Liao DP, Cai JW, Rosamond WD, Barnes RW, Hutchinson RG, Whitsel EA, Rautaharju P, Heiss G (1997) Cardiac autonomic function and incident coronary heart disease: a population-based case-cohort study—The ARIC study. Am J Epidemiol 145:696–706Google Scholar
  25. Riese H, Van Doomen LJP, Houtman ILD, de Geus EJC (2004) Job strain in relation to ambulatory blood pressure, heart rate, and heart rate variability among female nurses. Scand J Work Environ Health 30:477–485Google Scholar
  26. Schnall PL, Landsbergis PA, Baker D (1994) Job strain and cardiovascular disease. Annu Rev Public Health 15:381–411CrossRefGoogle Scholar
  27. Siegrist J (2001) A theory of occupational stress. In: Dunham J (ed) Stress in the workplace. Whurr Publishers, London, pp 52–66Google Scholar
  28. Sobolski J, Debacker G, Degre S, Kornitzer M, Denolin H (1981) Physical-activity, physical-fitness and cardiovascular-diseases—design of a prospective epidemiologic-study. Cardiology 67:38–51CrossRefGoogle Scholar
  29. Sobolski J, Kornitzer M, Debacker G, Dramaix M, Abramowicz M, Degre S, Denolin H (1987) Protection against ischemic-heart-disease in the belgian physical-fitness study—physical-fitness rather than physical-activity? Am J Epidemiol 125:601–610Google Scholar
  30. Steptoe A, Feldman RJ, Kunz S, Owen N, Willemsen G, Marmot M (2002) Stress responsivity and socioeconomic status—a mechanism for increased cardiovascular disease risk? Eur Heart J 23:1757–1763CrossRefGoogle Scholar
  31. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability—standards of measurement, physiological interpretation, and clinical use. Circulation 93:1043–1065Google Scholar
  32. Taylor HL, Jacobs DR, Schucker B, Knudsen J, Leon AS, Debacker G (1978) Questionnaire for the assessment of leisure-time physical activities. J Chronic Diseases 31:741–755CrossRefGoogle Scholar
  33. Thayer JF, Brosschot JF (2005) Psychosomatics and psychopathology: looking up and down from the brain. Psychoneuroendocrinology 30:1050–1058CrossRefGoogle Scholar
  34. Togo F, Takahashi M (2009) Heart rate variability in occupational health—a systematic review. Ind Health 47:589–602CrossRefGoogle Scholar
  35. Tsuji H, Venditti FJ, Manders ES, Evans JC, Larson MG, Feldman CL, Levy D (1994) Reduced heart-rate-variability and mortality risk in an elderly cohort—the Framingham heart-study. Circulation 90:878–883Google Scholar
  36. van Amelsvoort LGPM, Schouten EG, Maan AC, Swenne CA, Kok FJ (2000) Occupational determinants of heart rate variability. Int Arch Occup Environ Health 73:255–262CrossRefGoogle Scholar
  37. Vrijkotte TGM, van Doornen LJP, de Geus EJC (2000) Effects of work stress on ambulatory blood pressure, heart rate, and heart rate variability. Hypertension 35:880–886Google Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Els Clays
    • 1
  • Dirk De Bacquer
    • 1
  • Vincent Crasset
    • 2
  • France Kittel
    • 2
  • Patrick de Smet
    • 2
  • Marcel Kornitzer
    • 2
  • Robert Karasek
    • 3
    • 4
  • Guy De Backer
    • 1
  1. 1.Department of Public HealthGhent University, University HospitalGhentBelgium
  2. 2.Department of Epidemiology and Health Promotion, School of Public HealthFree University of BrusselsBrusselsBelgium
  3. 3.Department of Work EnvironmentUniversity of MassachusettsLowellUSA
  4. 4.Department of PsychologyCopenhagen UniversityCopenhagenDenmark

Personalised recommendations