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Relationship Between Cardiovascular Disease Morbidity, Risk Factors, and Stress in a Law Enforcement Cohort

Franke, Warren D. PhD; Ramey, Sandra L. PhD; Shelley, Mack C. II, PhD

Journal of Occupational and Environmental Medicine: December 2002 - Volume 44 - Issue 12 - p 1182-1189
Original Articles

It is unclear to what extent law enforcement officers (LEOs) experience increased prevalence of cardiovascular disease (CVD; defined as coronary heart disease, myocardial infarction, angina, or stroke) and, if so, whether perceived stress affects this relationship. First, self-reported CVD risk factors among currently employed male LEOs from 9 states (n = 2818) were compared to CVD risk factors among similarly-aged males with similar incomes in the same states (n = 8046). Second, CVD prevalence was compared among LEOs (n = 1791) and similarly-aged males with similar incomes (n = 2575) from four of these states. Finally, among the LEOs only, the possible effect of perceived stress on the relationship between CVD prevalence and CVD risk factors was assessed. LEOs reported higher prevalence of hypertension, hypercholesterolemia, tobacco use, and elevated body mass index. CVD prevalence did not differ significantly between the LEO group and the general population (2.3% ± 15% versus 3.1% ± 17%;P = 0.095). In the LEO-only group, the best predictors of CVD were: time in the profession (OR = 1.07; 95% CI = 1.03–1.11), perceived stress (OR = 1.05; 95% CI = 1.00–1.10), and hypertension (OR = 0.33; 95% CI = 0.18–0.62). In the LEO-only group, perceived stress was associated with CVD (P = 0.008), and three CVD risk factors were significantly affected by perceived stress: cholesterol, hypertension, and physical activity. Perceived stress was affected by duration of time in the profession (P = 0.004), independent of an age effect (P = 0.353). Among susceptible officers, perceived stress may contribute to CVD directly and through potentiating several CVD risk factors.

From the Department of Health and Human Performance (Dr Franke); Department of Educational Leadership and Policy Studies (Dr Ramey, Dr Shelley); Research Institute for Studies in Education (Dr Shelley); and the Department of Statistics (Dr Shelley), Iowa State University, Ames, IA.

Address correspondence to: Sandra L. Ramey, PhD, Grand View College 1200 Grandview Ave, Des Moines, IA 50316; e-mail:

Copyright © by American College of Occupational and Environmental Medicine

Copyright © 2002 by the American College of Occupational and Environmental Medicine