Study Title:

High Job Stress and Women's Heart Disease Risk

Study Abstract

This large-scale Danish study suggests that self-evaluated, overwhelming subjective pressure at work is likely to increase the risk of subsequent ischaemic heart diseases (IHD) among women, after adjustment for various conventional risk factors. These prospective data add to the literature proposing a causal association between work stress and coronary heart disease (CHD) among women. This is interesting, as the predictive and prognostic impact of work stress on CHD among women has rarely been studied using adequate research designs, and often unexpected or non-significant results have been reported. For instance, the Framingham offspring study, contrary to expectations, found that women with active jobs (high demands–high control) had an almost threefold higher risk of CHD compared to women with high job strain (high demands–low control),1 while for men the risk factors were not related to work stress. The Nurses' Health Study, on the other hand, found no association between job strain and CHD among women.

From press release:

High pressure jobs boost young women's risk of heart disease, finds a large study of female nurses published in Occupational and Environmental Medicine.

Previous research has indicated a link between a demanding job and heart disease risk, but the findings have been largely confined to men.

The research team assessed the impact of work pressure and degree of personal influence in the workplace on the heart health of 12,116 nurses, who were taking part in the Danish Nurse Cohort Study.

The nurses were all aged between 45 and 64 in 1993, when they were quizzed about their daily work pressures and personal influence, after which their health was then tracked for 15 years, using hospital records.

By 2008, 580 nurses had been admitted to hospital with ischaemic heart disease, which included 369 cases of angina and 138 heart attacks.

Nurses who indicated that their work pressures were a little too high were 25% more likely to have ischaemic heart disease as those who said their work pressures were manageable and appropriate.

But those who felt work pressures were much too high were almost 50% more likely to have ischaemic heart disease. After taking account of risk factors for heart disease, such as smoking and lifestyle, the risk fell to 35%, but still remained significant.

Poor job control in the workplace did not influence heart disease risk, while the amount of physical activity at work, which is known to affect health, had a small although significant impact.

When the findings were analysed by age, only the nurses under the age of 51 were at significant risk of heart disease.

In a separate analysis, the researchers looked at the impact of work pressures on the same group, but for just five years up to 1998.

Nurses who felt themselves to be moderately pressurised at work were 60% more likely to have ischaemic heart disease while those who said they faced excessive pressures at work were almost twice as likely to have it.

These findings held true even after taking account of other risk factors.

"It seems as if the effect of work pressure has a greater impact on younger nurses," say the authors. "This is in agreement with findings from previous studies looking at age specific effects in both men and women."

The lower risk among the older nurses may be due to other risk factors that become relatively more important with increasing age. Furthermore, vulnerable individuals may have [already] left work," they add.

Study Information

1.Ari Väänänen
Psychosocial work environment and risk of ischaemic heart disease in women
Occupational and Environmental Medicine,
2010 May
Danish Nurse Cohort Study

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