June/July 2015 (vol. 12/1)

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Research Plus

Stress raises risk of recurrent heart disease

Occupational stress significantly increases the risk of a subsequent coronary heart disease (CHD) event – such as a myocardial infarction or angina – in workers who have already suffered such an event, this systematic review and meta-analysis (of four studies) concludes. Work stress was assessed using validated instruments, based either on the demand–control or effort–reward imbalance (ERI) models. There was a 65% raised risk of recurrent CHD events associated with work stress (hazard ratio (HR) = 1.65; CI 1.23–2.22, p = 0.001). Both high work demand (HR = 1.42; CI 1.02–1.99) and low job control (HR = 1.44; CI 1.04–1.99) contributed to the risk in the demand–control model. For ERI, only low reward (HR 1.77; CI 1.16–2.71) had a significant effect. 

  1. Work stress and the risk of recurrent coronary heart disease events: A systematic review and meta-analysisInternational Journal of Occupational Medicine and Environmental Health 2015; 28(1); 8–19. doi: 10.2478/s13382-014-0303-7.


Occupational Health at Work June/July 2015 (vol. 12/1) pp35