Stressful Work Tied to
Heart Disease Death Risk
Excerpt By Amy Norton, Reuter's Health

NEW YORK (Reuters Health) - People who put much more into their jobs than they get back may be more likely to die of heart disease than those with more satisfying work, new study findings suggest.

Researchers in Finland found that among the more than 800 workers they followed over 25 years, those with either high job strain or so-called effort-reward imbalance had a more than twofold higher risk of death from cardiovascular disease than their peers.

Effort-reward imbalance means that an employee's job demands outweigh what's offered in return, in terms of money, career opportunities, job security and status. And while a number of studies have linked job stress to heart disease risk, this appears to be the first to specifically tie the mismatch between work effort and reward to the odds of dying from heart disease, the study's lead author told Reuters Health.

Dr. Mika Kivimaki and colleagues at the University of Helsinki studied 812 employees at factories owned by one manufacturer in central Finland. Their occupations ranged from "top management to shop-floor semi-skilled, blue collar workers," according to Kivimaki.

Regardless of the occupation, the researchers found, workers who reported high job strain--defined as a demanding job that allows the employee little control--were 2.2 times more likely to die of cardiovascular disease than workers with low job strain were. Similarly, employees who felt there was a large imbalance between their job effort and reward had a 2.4-times higher risk of cardiovascular death.

The findings are published in the October 19th issue of the British Medical Journal.

Both job strain and effort-reward imbalance are measures of overall work stress, and research in recent years has raised concerns that chronic job stress may boost a person's odds of heart disease. Kivimaki said that experts speculate that such long-term stress could have ill effects on hormonal and nervous-system functions key to the cardiovascular system. Some research also suggests that work woes could contribute to problems with blood clotting or insulin resistance, a precursor to diabetes, which in turn is a major risk factor for heart disease and stroke.

Kivimaki's team also found that greater job stress at the study's outset was associated with higher cholesterol and body mass index 5 to 10 years later--regardless of factors such as age, exercise habits and smoking.

Moreover, the link between job strain and cardiovascular disease was strongest among workers who were still doing the same job 5 years after their work-stress levels were measured. This is in line with the idea that chronic stress is more likely when a person sticks with the same job or workplace for the long haul, according to the researchers.

They point out, however, that neither demanding work nor an employee's intense efforts necessarily indicate "harmful stress." In this study, the authors note, these two factors alone were not related to cardiovascular death risk.

Still, they conclude, the findings support the "holistic" view that, in addition to established heart risks like smoking, inactivity and high-fat diets, psychological factors such as job stress are important as well.

SOURCE: British Medical Journal 2002;325:857-860.

Reference Source 89

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