Total cardiovascular risk assessment in people with high-stress occupation

Aim. To compare 10-year fatal cardiovascular event risk in people with high and low-stress occupation. To analyze main determinants of cardiovascular disease (CVD) prognosis and assess 10-year absolute risk of ischemic events in people with high-stress occupation.

Material and methods. In total, 449 22-55-year-old men with high and low levels of professional stress were examined. Group I included 240 locomotive brigade workers (mean age 42,39±9,06 years), Group II - 209 workers with low level of professional stress (mean age 41,1±8,7 years). Study methods included CVD risk factor assessment: smoking, CVD in family history, systolic blood pressure, body mass index, glycemia, and total cholesterol  level. In Group I, lipid profile (LP) and C-reactive protein (CRP) level were measured; 10-year total CVD risk was calculated with SCORE scale and 10-year absolute risk of myocardial infarction - by PROCAM scale.

Results. In people with high-stress occupation, hypercholesterolemia prevalence was higher by 21,4%, and high 10-year total coronary risk prevalence was higher by 8,7% (p<0,05). In those aged 45-55 years, high total coronary risk was 1,6 times more prevalent in Group I, comparing to Group II. In Group I, LP disturbances were observed. According to PROCAM scale, high coronary risk was more prevalent (25,0%), comparing to SCORE scale assessment (15,8%). Among people with high-stress occupation, CRP level was 6,7±0,9 mg/l in high coronary risk subjects and 3,1±0,3 mg/l in low to moderate risk individuals. Heart rate (HR) was 84,0±4,1 bpm and 75,8±1,6 bpm, respectively.

Conclusion. PROCAM scale was more informative than SCORE scale in total coronary risk assessment among people with high professional psycho-emotional stress. CRP and HR should be regarded as additional CVD risk factors in people with high-stress occupation.

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