Job strain is associated with a small but consistent increased risk of cardiovascular heart disease, a meta-analysis found.
Researchers analyzed individual records from 13 European cohort studies from 1985 to 2006 of employed men and women without coronary heart disease. Job strain was linked to records for the first non-fatal myocardial infarction or coronary death.
Results appeared early online Sept. 14 at The Lancet.
In the results, 30,214 (15%) of 197,473 participants reported job strain. In 1.49 million person-years at risk there were 2,358 events of incident coronary heart disease. After adjustment for sex and age, the hazard ratio [HR] for job strain versus no job strain was 1.23 (95% confidence interval [CI], 1.10 to 1.37).
This study found less of a risk from job strain the other published studies, researchers noted, likely because it included unpublished data and was twice as large as previously reported work. The effect estimate was higher in published (HR, 1.43; 95% CI, 1.15 to 1•77) than unpublished (HR, 1.16; 95% CI, 1.02 to 1.32) studies.
Prevention of workplace stress might decrease disease incidence, researchers wrote, but less so than addressing other risk factors, such as smoking.
"Primary-care practitioners need evidence-based information to advise patients with work-related stress," the researchers wrote. "The population attributable risk (PAR) in our study suggests that if the recorded association were causal, then job strain would account for a notable proportion of coronary heart disease events in working populations. However, the PAR is substantially less than that for standard risk factors, such as smoking (36% in INTERHEART), abdominal obesity (20%), and physical inactivity (12%)."