Are occupational stress levels predictive of ambulatory blood pressure in British GPs? An exploratory study

Background. Occupational stress has been implicated as an independent risk factor in the aetiology of coronary heart disease and increased hypertensive risk in a number of occupations. Despite the large number of studies into GP stress, none have employed an objective physiological stress correlate. Objectives. We conducted an exploratory study to investigate whether self-reported occupational stress levels as measured by the General Practitioner Stress Index (GPSI) were predictive of ambulatory blood pressure (ABP) using a Spacelabs 90207 in a sample of British GPs. Method. Twenty-seven GPs (17 males, 10 females) participated in the study. Each GP wore an ABP monitor on a normal workday and non-workday. All GPs completed the GPSI before returning the ABP monitors. Demographic data were also collected. Results. Stress associated with ‘interpersonal and organizational change’ emerged from the stepwise multiple regression analysis as the only significant predictor of ABP, explaining 21% of the variance in workday systolic blood pressure, 26% during the workday evening and 19% during the non-workday. For diastolic blood pressure, the same variable explained 29% of the variability during the workday and 17% during the non-workday. No significant gender differences were found on any of the ABP measures. Conclusions. For the first time in GP stress research, our findings established that higher levels of self-reported occupational stress are predictive of greater ABP in British GPs. More detailed psychophysiological research and stress management interventions are required to isolate the effects of occupational stress in British GPs.