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February/March 2015 (vol. 11/5)
Stress and the risk of coronary heart disease
Work stress increases the risk of recurrent coronary heart disease (CHD) events by two-thirds (65%), according to this systematic review and meta-analysis. It focused on papers with follow-up greater than three years, where end points were either cardiac death or myocardial infarction, and where work stress was measured using validated instruments; five papers met these criteria. Work stress – defined according to the demand–control or effort–reward imbalance models – was associated with a significant raised risk of CHD events (hazard ratio (HR) = 1.65; CI = 1.23–2.22). The pooled HRs for high demand and low control were 1.42 (CI 1.02–1.99) and 1.44 (CI 1.04–1.99) respectively; and for high effort and low reward were 1.17 (not significant) and 1.77 (CI 1.16–2.71), respectively. Workplace interventions aimed at improving the psychosocial work environment are warranted.
Occupational Health at Work February/March 2015 (vol. 11/5) pp39