The association between job strain and coronary heart disease: A meta-analysis of prospective cohort studies

Shuxian Xu,Yuli Huang,Jiping Xiao,Wenjing Zhu,Lulu Wang,Hongfeng Tang,Yunzhao Hu,Tiebang Liu

doi:10.3109/07853890.2015.1075658

Abstract

Background. Studies about work stress and the risk of coronary heart disease (CHD) have yielded inconsistent results. This meta-analysis aimed to investigate the association between job strain and the risk of CHD.Methods. We searched PubMed and Embase databases for studies reporting data on job strain and the risk of CHD. Studies were included if they reported multiple-adjusted relative risk (RR) with 95% confidence interval (CI) with respect to CHD from job strain.Results. Fourteen prospective cohort studies comprising 232,767 participants were included. The risk of CHD was increased in high-strain (RR 1.26; 95% CI 1.12–1.41) and passive jobs (RR 1.14; 95% CI 1.02–1.29) but not in active jobs (RR 1.09; 95% CI 0.97–1.22), when compared with low-strain group. The increased risk of CHD in high-strain and passive jobs was mainly driven by studies with a follow-up duration of ≥ 10 years. Neither the low-control (RR 1.06; 95% CI 0.93–1.19) nor high-demand (RR 1.13; 95% CI 0.97–1.32) dimension was independently associated with the risk of CHD.Conclusions. Individuals with high-strain and passive jobs were more likely to experience a CHD event. Intervention programs incorporating individual and organizational levels are crucial for reducing job strain and the risk of CHD.

Highlights

Extensive research has provided evidence that psychosocial stressors can increase the risk of cardiovascular disease (CVD), including hypertension [1], coronary heart disease (CHD) [2], arrhythmia [3], and stroke [4]
Studies were eligible if they met the following criteria: 1) prospective cohort study; 2) job strain categories or their components were measured at baseline; 3) follow-up duration 3 years with assessment of CHD; 4) the study reported multivariate-adjusted relative risks (RRs) or hazard ratios (HRs) and 95% confidence intervals (CIs) for events associated with high-strain, active, or passive jobs versus low-strain jobs, or if RRs and 95% CIs were reported for high demands versus low demands or low control versus high control, respectively
In this study we found that, after controlling for multiple cardiovascular risk and socio-economic factors, high-strain and passive jobs were significantly associated with an increased risk of CHD compared with low-strain jobs, especially in studies with a follow-up duration of more than 10 years

Summary

Introduction

Extensive research has provided evidence that psychosocial stressors can increase the risk of cardiovascular disease (CVD), including hypertension [1], coronary heart disease (CHD) [2], arrhythmia [3], and stroke [4]. Studies about work stress and the risk of coronary heart disease (CHD) have yielded inconsistent results. This metaanalysis aimed to investigate the association between job strain and the risk of CHD. The risk of CHD was increased in highstrain (RR 1.26; 95% CI 1.12–1.41) and passive jobs (RR 1.14; 95% CI 1.02–1.29) but not in active jobs (RR 1.09; 95% CI 0.97–1.22), when compared with low-strain group. The increased risk of CHD in high-strain and passive jobs was mainly driven by studies with a follow-up duration of 10 years. Neither the low-control (RR 1.06; 95% CI 0.93–1.19) nor high-demand (RR 1.13; 95% CI 0.97–1.32) dimension was independently associated with the risk of CHD.

Methods

Results

Conclusion