Physiology of Stress and Regeneration in Job Related Cardiovascular Illness

Abstract The possible physiological significance of individual control over environmental/occupational stressors has not been discussed systematically in relation to cardiovascular disease. In this paper we review associations between stressors and control in the work situation and endocrine, metabolic, and cardiovasclar activity, using the categories “anabolic” and “catabolic” to organize the findings in relation to the development of ischemic cardiovascular disease. We propose a comprehensive hypothesis, related to existing stress models which incorporates potential physiological regenerative or ameliorating—as well as pathologic—effects of stressor exposure. Regenerative processes are hypothesized to occur in circumstances where equilibrium or a match exists between environmental demands and possibilities for individual control over those demands, whereas pathologic consequences would occur when demands exceed control. This theory is further proposed to account for cardiovascular pathophysiologic differences found between occupational groups. Finally, empirical testing of the validity of this theory is discussed.