Screening of Pathophysiological Mechanisms and Psychological and Occupational Factors, Determining Risk of Cardiovascular Diseases in High-Risk Professions

Cardiovascular diseases (CVD) are among the most significant and common chronic non-communicable diseases in Bulgaria. Screening, identification and registration of pathophysiological mechanisms and psychological and occupational factors related to CVD should be implemented in the diagnostic work-up. Job analysis contributes to the implementation of screening and identification of the most significant psychological and professional factors related to the work activity. Aim: The aim of our study is to examine the pathophysiological mechanisms of autonomic cardiovascular control and psychological and occupational factors determining the risk of CVD. Materials and methods: The following groups of individuals were examined: 83 physicians, 54 nurses, 23 employees and 40 militaries. The autonomic cardiovascular control was studied through the time-and frequency-domain based measures of the Analysis of Heart Rate Variability (HRV). Results: The results of the ANOVA test showed that there was a statistically significant difference in the time-domain and frequency-domain based HRV measures between the compared groups: X [F (4; 225) = 4.455, p = 0.001]; SDNN [F (4; 225) = 3.876, p = 0.005]; SDNN5 [F (4; 225) = 3.083, p = 0.01]; pNN50 [F (4; 225) = 8.303, p < 0.001]; rMSSD [F (4; 225) = 8.711, p < 0.001]; SDSD [F (4; 225) = 8.323, p < 0.001; VLF [F (4; 225) = 1.204, p = 0.31]; LF [F (4; 225) = 3.874, p = 0.005]; HF [F (4; 225) = 7.790, p < 0.001] and LF/HF [F (4; 225) = 8.601, p < 0.001]. The results of our study revealed that occupational stress and cognitive workload in physicians, nurses, and employees induced a process of reciprocally combined inhibition of the parasympathetic branch of the autonomic nervous system (ANS) (SDNN, SDNN5, pNN50, rMSSD, and HF) and activation of the sympathetic branch of ANS (LF), while in military personnel they cause a process of co-activation of the parasympathetic and sympathetic branches of the ANS (rMSSD, SDNN, SDNN5, pNN50 and LF/HF). Conclusion: Stress-induced dysfunctional autonomic cardiovascular regulation, patho-physiological control mechanisms, psychological and occupational factors determine the risk of CVD. Their identification could contribute to the diagnostics and prevention of CVD.

Abstract licence: CC BY-NC-ND

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   Psychosocial interventions for managing occupational stress and burnout among medical doctors: a systematic review · 2017

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