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Researchers say job stress as well as effort-reward imbalance can affect heart health. PER Images/Stocksy
  • Stress is known to have a number of negative health effects, including on your heart.
  • One of the most common sources of stress can be your job.
  • A new study links specific types of work stress to coronary heart disease.

Time spent at work can be, and often is, the most stressful part of the day for a significant portion of adults.

Frequently, the results of decades of stressful work is a host of health issues, not the least of which can be coronary heart disease.

In a research article published today in the journal Circulation: Cardiovascular Quality and Outcomes, scientists examined 18 years of data collected from more than 6,400 participants to determine how various types of work stress might lead to heart disease.

The results?

High stress work can double the chances of men developing heart disease, which can cause heart attacks and other complications.

This researchers looked at two types of work stress.

The first was job strain, which is defined as work where the demands on the worker are high and the worker has low control over their own work.

Active jobs have both high demand and control. Passive jobs have both low demand and low control. When demands are low and control is high, it’s considered a low strain job.

Secondly, researchers measured effort-reward imbalance. This method measured whether the demands of a person’s job were aligned with their compensation, including such things as salaries, promotion opportunities, and job stability.

“This study expands on our prior knowledge of the risk of heart events related to work stress,” Dr. Joseph Ebinger, a clinical cardiologist and director of Clinical Analytics at the Smidt Heart Institute at Cedars-Sinai in Los Angeles, told Medical News Today.

“Specifically, the researchers looked at the association not just of work stress or [effort-reward imbalance] alone, but the risk when these occur together,” said Ebinger, who was not involved in the study.

Some workers in the study experienced job strain, some experienced effort-reward imbalance, and some experienced both.

The participants without effort-reward imbalance who also had low job strain acted as a control group.

Among men, experiencing either job strain or effort-reward imbalance was associated with a 49% increased risk of coronary heart disease compared to their control counterparts.

Job strain and effort-reward imbalance together increased coronary heart disease risk by 103%.

“This is quite a huge effect size and it is impressive that the researchers followed 6,000 people over 18 years,” Dr. Alex Dimitriu, an expert in psychiatry and sleep medicine as well as the founder of Menlo Park Psychiatry & Sleep Medicine in California, told Medical News Today.

“There is no doubt that being rushed, feeling unprepared, or feeling unappreciated can increase stress levels,” said Dimitriu, who was not involved in the study.

Stress is sometimes treated as an emotional state, but expert say there are many physiological effects as well.

“Stress triggers your ‘fight or flight’ response, driving up stress hormones, blood pressure, and heart rate. This can have both immediate and long-term effects on the body,” said Ebinger.

Results among women in this study were inconclusive, but experts say women aren’t immune from the effects of stress.

“The study focused on only one type of heart disease, meaning that women with high stress may be at increased risk for other heart or non-heart-related events,” noted Ebinger.

“Indeed, women showed inconclusive results — and estrogen may be protective — however the authors agree the impact may become apparent later than for men. There is no doubt men and women will benefit from improved self care while also reducing work related stress,” said Dimitriu.

While experts agree this study is useful, they said there are a number of ways in which it could be improved in the future.

“I don’t believe that baseline anxiety or psychiatric conditions were assessed in the participants; it is possible that some people may be more sensitive to stress than others,” said Dimitriu.

“鲍苍蹿辞谤迟耻苍补迟别濒测, sleep quality and duration was not looked at either, and this can also play a tremendous part in how people are impacted by stress,” Dimitriu added.

The pool of participants may also have affected the study’s results.

“This study was performed in Canadian white-collar workers, which may limit our ability to extrapolate the findings to other populations or jobs,” said Ebinger.

“Further, they assessed work stress and [effort-reward imbalance] at the beginning of the study and not over time, so we cannot say how changes in work-related stress may affect your heart risk,” Ebinger added.

And while this study found an association between work stress and coronary heart disease, it doesn’t prove that one causes the other.

“Basically, we can say that the association between work stress and heart events is present, but cannot answer the question of how or why that association exists,” Ebinger said.

Reducing stress in all areas of life is an important pursuit and also an ongoing one.

“It’s impossible to remove all stress from our lives. Learning to effectively manage that stress is key,” said Ebinger.

“Work stress is a problem of both quantity (how much you work) and quality (the intensity of your work, and your reactions to it), and for some people it may be necessary to reduce both if it feels too much,” said Dimitriu.

“Others may be particularly sensitive or anxious, or tired, or depressed, all of which can make for a hard day. In those cases, it’s important to address the underlying cause, and possibly speak with a doctor or therapist,” Dimitriu added, suggesting that people feeling stressed should prioritize sleep, exercise, a healthy diet, socialization, time in nature, and silence.

“Establishing a relationship with a mental health professional and regular check ins with your cardiologist can help keep you happy and healthy,” Ebinger said.