Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES).

Karasek, Robert; Theorell, Töres; Schwartz, Joseph E.; Schnall, Peter L.; Pieper, Carl F.; Michela, John L.

doi:10.2105/ajph.78.8.910

Cited by 563 publications

(277 citation statements)

References 22 publications

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“…Because increased BP reactivity can be a risk factor for cardiovascular disease, 45,46 the current results provide further evidence that high job strain places individuals at risk for cardiovascular disease. 2,29,30 Secondary analyses were conducted to determine whether job strain moderated the relationship between ethnicity and pressor sensitivity. Specifically, we wondered whether the heightened pressor sensitivity in blacks that we observed in previous studies 19 could be partially explained by job strain.…”

Section: Discussionmentioning

confidence: 99%

“…10 Further, several studies support the use of the DC model in predicting cardiovascular disease risk. [2][3][4][25][26][27][28][29][30][31][32][33] …”

Section: Job Strainmentioning

confidence: 99%

“…1,2 Generally, these works have measured casual or ambulatory blood pressure (BP). These studies generally demonstrate that job strain is associated with increased BP throughout the day and night.…”

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confidence: 99%

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Job Strain, Ethnicity, and Sympathetic Nervous System Activity

et al. 2004

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Abstract-Several studies have demonstrated that blacks have heightened pressor sensitivity in response to the ␣-agonist, phenylephrine. However, studies examining whether psychosocial factors contribute to this difference are scarce. We examined the effects of job strain on pressor sensitivity in 76 whites and 46 blacks who were enrolled in a study of stress, sleep, and blood pressure. Responses to phenylephrine were examined at an inpatient clinical research center. After a 3-minute baseline period, a 100-microgram phenylephrine bolus was administered to participants intravenously. To measure catecholamines, 24-hour urine samples were also collected from participants. There was a significant relationship between job strain and pressor sensitivity, such that individuals with low decisional control and high job demands experienced a greater increase in diastolic pressure after receiving phenylephrine. Low decisional control was also associated with decreased baroreflex sensitivity. There was an interaction between ethnicity and job control on blood pressure responses to phenylephrine and on 24-hour urinary norepinephrine levels. Blacks who perceived less control experienced a greater increase in diastolic pressure after receiving phenylephrine and had elevated norepinephrine levels. These findings suggest possible mechanisms by which job strain may be associated with cardiovascular disease.

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Section: Discussionmentioning

confidence: 99%

“…10 Further, several studies support the use of the DC model in predicting cardiovascular disease risk. [2][3][4][25][26][27][28][29][30][31][32][33] …”

Section: Job Strainmentioning

confidence: 99%

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Job Strain, Ethnicity, and Sympathetic Nervous System Activity

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“…. [p 910]" (32). In cases of duplicate reports, we selected the one with a more valid assessment of the exposure or outcome or, if there was no difference in this respect, the paper first published.…”

Section: Criteria For Inclusionmentioning

confidence: 99%

Work stress in the etiology of coronary heart disease—a meta-analysis

Kivimäki¹,

Virtanen²,

Elovainio³

et al. 2006

Scand J Work Environ Health

763

552

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Kivimäki M, Virtanen M, Elovainio M, Kouvonen A, Väänänen A, Vahtera J. Work stress in the etiology of coronary heart disease-a meta-analysis. Scand J Work Environ Health 2006;32(6 special issue):431-442.Objectives This study focused on estimating the relative risk of coronary heart disease (CHD) in association with work stress, as indicated by the job-strain model, the effort-reward imbalance model, and the organizational injustice model. MethodsA systematic review and meta-analysis of prospective cohort studies were carried out. Studies were eligible if they had published a quantitative estimate of the association between work stress and incident CHD or cardiovascular mortality by January 2006.Results Fourteen prospective cohort studies were identified. For a total of 83 014 employees, the age-and gender-adjusted relative ratio of CHD for high versus low job strain was 1.43 [95% confidence interval (95% CI) 1.15-1.84], but the ratio decreased to 1.16 (95% CI 0.94-1.43) after adjustment for risk factors and potential mediators. The age-and gender-adjusted risk ratio for a combination of high efforts and low rewards was 1.58 (95% CI 0.84-2.97) for 11 528 employees, and no reduction in the risk ratio was seen after further adjustments. For organizational injustice, the age-and gender-adjusted, and multiple-adjusted relative risks were 1.62 (95% CI 1.24-2.13) and 1.47 (95% CI 1.12-1.95), respectively, for a population of 7246 men and women. There was little standardization in the assessment of work stress within all three stress models, and significant heterogeneity in the effects of stress was observed between studies. Few studies were available for female samples. ConclusionsObservational data suggest an average 50% excess risk for CHD among employees with work stress. Further research is needed to confirm that a reduction in work stress will lead to a reduction in CHD risk.Key terms cardiovascular disease; effort-reward imbalance; job strain; mortality; organizational justice; prospective cohort study; psychosocial factors; systematic review; working population. Activation of the stress system in the hypothalamus and the brain stem helps the body to overcome the influence of short-term physical stressors. However, prolonged overactivity of these systems may cause wear and tear and play a role in coronary heart disease (CHD), infection, and accelerated aging (1). The recognition that the physiological reactions to stress cannot only protect, but also damage the body has provided a basis for epidemiologic research on work stress.Three models for work stress and coronary heart disease Work-stress models aim at describing factors that are likely to elicit harmful stress at work in a large proportion of employees. These factors are conceptualized at a level of generalization that allows for their identification in a wide range of occupations. The stress model most often cited and most widely tested is the two-dimensional job-strain model (2-4) ( Work stress in the etiology of coronary heart disease strain model adds...

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“…However, after the middle of the 20th century this changed gradually, especially in Westernized countries, so that CVD is currently more common in lower socio-economic groups (6)(7)(8)(9) . Moreover, nowadays observational studies show that low SES individuals are associated with increased prevalence of CVD risk factors, such as hypertension, sedentary life, unhealthy dietary habits, cigarette smoking and high cholesterol (10)(11)(12)(13) . It has been hypothesized that dietary choices may be one of the many factors mediating the relationship between social class and CVD risk.…”

mentioning

confidence: 99%

Dietary habits mediate the relationship between socio-economic status and CVD factors among healthy adults: the ATTICA study

Panagiotakos

Pitsavos

Chrysοhoou

et al. 2008

Public Health Nutr.

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Background: The aims of the present work were to investigate whether dietary habits are associated with socio-economic status (SES), and if they modify the relationship between SES and CVD risk factors, in a sample of men and women free from known CVD.Methods: This population-based study was carried out in the province of Attica, where Athens is a major metropolis. During 2001-2002, information from 1528 men (18-87 years old) and 1514 women (18-89 years old) was collected (75 % participation rate). Among several sociodemographic, clinical and biological factors, adherence to the Mediterranean diet was assessed by a special diet score (Mediterranean Diet Score, MDS) that incorporated the inherent characteristics of this traditional diet. CVD risk factors were examined across the participants' educational level and annual income that defined their SES. Results: Low SES groups exhibited higher prevalence of CVD risk factors, such as obesity, hypertension, diabetes mellitus and hypercholesterolaemia (all P , 0?001). Low SES groups also showed less adherence to the Mediterranean diet than high SES groups (MDS: 23?6 (SD 8?1) v. 25?6 (SD 5?6), P , 0?001). Higher SES index was associated with lower likelihood of having hypercholesterolaemia (OR 5 0?91; 95 % CI 0?83, 1?00) and diabetes (OR 5 0?83; 95 % CI 0?72, 0?95), after adjusting for various potential confounders. However, the previously mentioned inverse relationship observed between SES and prevalence of CVD risk factors was mainly explained by the dietary habits of the participants. Conclusions: Low SES groups showed less adherence to the Mediterranean diet compared with high SES groups. This finding may, in part, explain the higher CVD risk factors profile observed among low SES participants.

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Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES).

Abstract: Associations between psychosocialjob characteristics and past myocardial infarction (MI) prevalence for employed males were tested with the Health Examination Survey (HES) 1960-61, N = 2,409, and the Health and Nutrition Examination Survey (HANES) 1971-75, N = 2,424.

Cited by 563 publications

References 22 publications

Job Strain, Ethnicity, and Sympathetic Nervous System Activity

Job Strain, Ethnicity, and Sympathetic Nervous System Activity

Work stress in the etiology of coronary heart disease—a meta-analysis

Dietary habits mediate the relationship between socio-economic status and CVD factors among healthy adults: the ATTICA study

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