Men with cardiometabolic disease are at a raised risk of death if they experience job strain, researchers warn today.
The same risk was not seen for women, report Professor Mika Kivimaki, of University College London, UK, in The Lancet Diabetes & Endocrinology.
They aimed to strengthen the evidence base for a potential risk of work stress in cardiovascular disease. To do so, they used figures from 102,633 people in seven European studies.
They defined work stress as job strain or effort-reward imbalance at work, taking into account socioeconomic status, biological and lifestyle risk factors.
Analysis showed that, in men with cardiometabolic disease – coronary heart disease, stroke, or diabetes – mortality rates were 68% higher in those with job strain.
"This mortality difference for job strain was almost as great as that for current smoking versus former smoking, and greater than those due to hypertension, high total cholesterol concentration, obesity, physical inactivity, and high alcohol consumption relative to the corresponding lower risk groups," the authors state.
The risk related to job strain was also seen in men who had achieved treatment targets, they add. In all women, and in men without cardiometabolic disease, work stress did not seem to be linked to risk of death.
Professor Kivimaki says: "These findings suggest that controlling blood pressure and cholesterol levels alone are unlikely to eliminate the excess risk associated with job strain in men with cardiometabolic disease.
"Other interventions might be needed at least for some patients – possibly including stress management as part of cardiovascular disease rehabilitation, job redesign, or reducing working hours."
Kivimaki, M. et al. Work stress and risk of death in men and women with and without cardiometabolic disease: a multicohort study. The Lancet Diabetes & Endocrinology 5 June 2018 doi: 10.1016/S2213-8587(18)30140-2
http://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30140-2/fulltext
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