The association between job strain and coronary heart disease: a meta-analysis of prospective cohort studies

Ann Med. 2015;47(6):512-8. doi: 10.3109/07853890.2015.1075658. Epub 2015 Sep 7.

Abstract

Background: Studies about work stress and the risk of coronary heart disease (CHD) have yielded inconsistent results. This meta-analysis aimed to investigate the association between job strain and the risk of CHD.

Methods: We searched PubMed and Embase databases for studies reporting data on job strain and the risk of CHD. Studies were included if they reported multiple-adjusted relative risk (RR) with 95% confidence interval (CI) with respect to CHD from job strain.

Results: Fourteen prospective cohort studies comprising 232,767 participants were included. The risk of CHD was increased in high-strain (RR 1.26; 95% CI 1.12-1.41) and passive jobs (RR 1.14; 95% CI 1.02-1.29) but not in active jobs (RR 1.09; 95% CI 0.97-1.22), when compared with low-strain group. The increased risk of CHD in high-strain and passive jobs was mainly driven by studies with a follow-up duration of ≥ 10 years. Neither the low-control (RR 1.06; 95% CI 0.93-1.19) nor high-demand (RR 1.13; 95% CI 0.97-1.32) dimension was independently associated with the risk of CHD.

Conclusions: Individuals with high-strain and passive jobs were more likely to experience a CHD event. Intervention programs incorporating individual and organizational levels are crucial for reducing job strain and the risk of CHD.

Keywords: Coronary heart disease; job strain; meta-analysis; work stress.

Publication types

  • Meta-Analysis

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cohort Studies
  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / etiology
  • Coronary Artery Disease / psychology*
  • Employment / psychology
  • Female
  • Humans
  • Job Satisfaction
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Stress, Psychological / diagnosis
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / psychology*
  • Workload / psychology*
  • Young Adult