Work Related Stress and Coronary Heart Disease

New research from Universite Laval's Faculty of Medicine published in the Journal of the American Medical Association has demonstrated that chronic job strain after a first heart attack may double the risk of suffering a second one.

Researchers explain that previous studies had confirmed a relationship between work-related stress and a first coronary heart disease (CHD) event, but the few studies conducted on the association with recurrent CHD were limited in scope and inconsistent in their findings.

Researchers led by Chantal Brisson followed a group of 972 people aged 35 to 59 who had suffered a heart attack. They were interviewed at six weeks, two and six years after returning to work concerning their health, lifestyle, socio-demographic status, and degree of work stress. A job was defined as stressful "if it combined high psychological demands (heavy workload, intense intellectual activity, and important time constraints) and little control over decision-making (lack of autonomy, creativity, and opportunities to use or develop skills)."

The study found that 124 participants suffered a second heart attack and 82 experienced unstable angina. People reporting high levels of work stress at six weeks and two years were twice as likely to suffer another CHD event. Researchers found that the risk remained the same after allowing for variables such as severity of the first heart attack, other health conditions, family history, lifestyle, socio-demographic status, personality, and other work-environment factors. They also found that job strain did not increase the probability of experiencing a second CHD event during the first two years.

Chantal Brisson commented:

"It makes sense on a biomedical level, since the pathological process at the source of the CHD requires some time before it can manifest itself."

The researchers conclude that these findings should alert employers to the need to protect people from potentially harmful situations when they return to work after a heart attack.

Chantal Brisson said:

"Employers and occupational health service professionals must find ways to modify the psychological demands of a job or the level of control over decision-making for people returning to work after a heart attack. It can be done, and encouraging autonomy, creativity, and the development of professional abilities in the workplace is not incompatible with a company's productivity."