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Job Strain Ups Risk of Coronary Heart Disease

Hazard ratio is also increased in studies addressing reverse causality
FRIDAY, Sept. 14 (HealthDay News) -- Job strain is associated with an increase in the risk of coronary heart disease, according to a meta-analysis published online Sept. 14 in The Lancet.
Mika Kivimäki, Ph.D., from University College London, and colleagues conducted a meta-analysis of individual records from 13 European cohort studies involving 197,473 participants, to examine the relation between job strain and coronary heart disease. Job strain was assessed from validated job-content and demand-control questionnaires.
The researchers found that 15 percent of participants reported job strain. During a mean follow-up of 7.5 years, 2,358 events of incident coronary heart disease (first nonfatal myocardial infarction or coronary death) were recorded. The hazard ratio for job strain versus no job strain was 1.23, even after adjustment for sex, age, lifestyle, and socioeconomic status. The effect estimate was elevated in published versus unpublished studies (1.43 versus 1.16). Analyses that addressed reverse causality by exclusion of events of coronary heart disease that occurred in the first three and five years of follow-up also showed raised hazard ratios (1.31 and 1.30, respectively). There was a 3.4 percent population attributable risk for job strain.
"Our findings suggest that prevention of workplace stress might decrease disease incidence; however, this strategy would have a much smaller effect than would tackling of standard risk factors, such as smoking," the authors write.
Abstract (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60994-5/abstract )Full Text (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60994-5/fulltext )Editorial (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61512-8/fulltext )
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