Occupational stress and subclinical atherosclerosis: a systematic review

Abstract

Background: Stress is a common hazard in the work environment and is associated with multiple adverse health effects. The association between work-related stress (WRS) and cardiovascular disease has been established in a number of epidemiological studies. Methods: A systematic review was conducted according to the PRISMA statement of the English literature involving WRS and carotid artery intima media thickness (CIMT). Results: Four cohorts and six cross-sectional studies of occupational stress and CIMT were identified. All cohorts and five of the cross-sectional studies reported a significant positive association, while one reported an inverse association of WRS and CIMT. Discussion: The weight of the evidence that we were able to identify suggests that occupational stress results in an increased risk of atherosclerosis, assessed via CIMT. Studies that include longitudinal measures of stress and intermediate cardiac endpoints, with adequate accounting for confounders, are needed. Interventional studies should also be conducted to determine whether CIMT progression can be prevented with workplace stress reduction.

Number of recent stressful life events and incident cardiovascular disease: Moderation by lifetime depressive disorder

“…Second, chronic exposure to stress may instigate atherogenic behaviors, including tobacco use and alcohol abuse, high fat and carbohydrate consumption, and physical inactivity (46, 47). Further supporting these candidate mechanisms, stressful life events have been cross-sectionally associated with increased endothelial dysfunction (48), and chronic work stress has been prospectively related to progression of subclinical atherosclerosis (49). However, in the current study, which is limited by two waves of data collection, we did not investigate these candidate mechanisms.…”

Exposing the impact of Citizens Advice Bureau services on health: a realist evaluation protocol

“…There is a plethora of research to link stress, anxiety and depression with other aspects of physical health. 31–35 Using this mental health, lens will allow us to theorise on the distal physical health impacts CAB may have, which cannot be documented through empirical data collection.…”

Environmental tobacco smoke (ETS) and hyperlipidemia modified by perceived work stress

“…Work-related stress has also been neglected as a contributing factor for CVDs. Some civil servants, such as police officers and firefighters, frequently have stressful workloads, shift changes, overnight work, and erratic work schedules [7][8][9]. Long-term exposure to crises and high-pressure situations can easily cause atherosclerosis and CVDs.…”