Lethal Combo: This Pair of Stressors Doubles Men’s Heart Disease Risk
By AMERICAN HEART ASSOCIATION
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The impact of job strain and effort-reward
imbalance combined was similar to the magnitude of the impact of obesity on the
risk of coronary heart disease, in the study of nearly 6,500 white-collar
workers in Canada.
Results on how work stress affects
women’s heart health were inconclusive.
Men who say they have stressful jobs and also
feel they exert high efforts for low reward had double the risk of heart
disease compared to men free of those stressors, according to new research
published on September 19 in Circulation: Cardiovascular
Quality and Outcomes, a peer-reviewed American Heart Association
journal.
“Considering the significant amount of time people spend at work, understanding the relationship between work stressors and cardiovascular health is crucial for public health and workforce well-being,” said lead study author Mathilde Lavigne-Robichaud, R.D., M.S., doctoral candidate, Population Health and Optimal Health Practices Research Unit, CHU de Quebec-University Laval Research Center in Quebec, Canada.
“Our study
highlights the pressing need to proactively address stressful working conditions,
to create healthier work environments that benefit employees and employers.”
Heart Disease: A Leading Concern
Heart disease holds the dubious distinction
of being the top cause of death in the U.S. according to American Heart Association
statistics. In 2020 alone, nearly 383,000 Americans died of
heart disease.
Research has shown that two psychosocial
stressors — job strain and effort-reward imbalance at work — may increase heart
disease risk. However, few studies have examined the combined effect.
“Job strain refers to work environments where
employees face a combination of high job demands and low control over their
work. High demands can include a heavy workload, tight deadlines and numerous
responsibilities, while low control means the employee has little say in
decision-making and how they perform their tasks,” Lavigne-Robichaud explained.
“Effort-reward imbalance occurs when
employees invest high effort into their work, but they perceive the rewards
they receive in return — such as salary, recognition or job security — as
insufficient or unequal to the effort. For instance, if you’re always going
above and beyond, but you feel like you’re not getting the credit or rewards you
deserve, that’s called effort-reward imbalance.”
Key Study Findings
The study reveals:
Men who said they experienced either job
strain or effort-reward imbalance had a 49% increase in risk of heart disease
compared to men who didn’t report those stressors.
Men reporting both job strain and
effort-reward imbalance were at twice the risk of heart disease compared with
men who did not say they were experiencing the combined stressors.
The impact of psychosocial stress at work on
women’s heart health was inconclusive.
In men, the impact of job strain and
effort-reward imbalance combined was similar to the magnitude of the impact of
obesity on the risk of coronary heart disease.
“Our results suggest that interventions aimed at reducing stressors from the work environment could be particularly effective for men and could also have positive implications for women, as these stress factors are associated with other prevalent health issues such as depression,” Lavigne-Robichaud said.
“The study’s inability to establish a direct link
between psychosocial job stressors and coronary heart disease in women signals
the need for further investigation into the complex interplay of various
stressors and women’s heart health.”
Potential Interventions and Broader Implications
Interventions might include different
approaches, such as providing support resources, promoting work-life balance,
enhancing communication, and empowering employees to have more control over
their work, she said.
“The U.S. workforce is among the most stressed in the world, and these workplace stressors can be as harmful to health as obesity and secondhand smoke,” Eduardo J. Sanchez, M.D., M.P.H., FAHA, FAAFP, chief medical officer for prevention at the American Heart Association.
“This study adds to the growing body of evidence that the
workplace should be prioritized as a vehicle for advancing cardiovascular
health for all. The American Heart Association remains committed to and engaged
in providing employers with the resources and information they need to actively
support the health of their employees and communities through science-backed
changes to policy and culture.”
Study Specifics
Study background and details:
Researchers studied nearly 6,500 white-collar
workers, average age about 45 years old, without heart disease, and followed
them for 18 years, from 2000 to 2018.
They studied health and workplace survey
information for 3,118 men and 3,347 women in a wide range of jobs in Quebec.
The surveys included employees working in senior management, professional,
technical, and office worker roles. Education levels ranged from no high school
diploma to a university degree.
Researchers measured job strain and
effort-reward imbalance with results from proven questionnaires and retrieved
heart disease information using established health databases.
One study limitation is that the researchers
studied men and women in white-collar jobs primarily in Quebec, Canada, and the
results might not fully represent the diversity of the American working
population. However, the study findings may be relevant to white-collar workers
in the United States and other high-income countries with similar job
structures, according to Lavigne-Robichaud.
Reference: “Psychosocial Stressors at Work
and Coronary Heart Disease Risk in Men and Women: 18-Year Prospective Cohort
Study of Combined Exposures” by Mathilde Lavigne-Robichaud, Xavier Trudel,
Denis Talbot, Alain Milot, Mahée Gilbert-Ouimet, Michel Vézina, Danielle
Laurin, Clermont E. Dionne, Neil Pearce, Gilles R. Dagenais and Chantal
Brisson, 19 September 2023, Circulation: Cardiovascular Quality and
Outcomes.
DOI: 10.1161/CIRCOUTCOMES.122.009700
