Work stress and the risk of recurrent coronary heart disease events: A systematic review and meta-analysis

Li, Jian; Zhang, Min; Loerbroks, Adrian; Angerer, Peter; Siegrist, Johannes

doi:10.2478/s13382-014-0303-7

Cited by 75 publications

(60 citation statements)

References 65 publications

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“…Different definitions of job stress exist, including the job demand/control model, which has also proven its usefulness for predicting incident episodes of somatic diseases and prognosis. 42,43 Other models refer to injustice at work and illegitimate tasks as key issues evoking job stress leading to adverse physical and mental health outcomes. For instance, work engagement may lead to depressive and anxiety symptoms, 44 both of which have been shown to be increased in patients with IBD and to also adversely impact the course of the disease.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Determinants of Job Stress in Patients with Inflammatory Bowel Disease

Schreiner

Biedermann

Rossel

et al. 2017

Inflammatory Bowel Diseases

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BACKGROUND Psychosocial factors have been shown to predict a poor disease course in patients with inflammatory bowel disease (IBD), but whether this applies to job stress is currently unknown. We assessed the prevalence of job stress and its correlates in a large cohort of patients with IBD. METHODS We included all adult, professionally active patients enrolled between 2006 and 2015 in the Swiss IBD Cohort. Job stress was measured through the self-report effort-reward imbalance ratio and overcommitment (OC) to work questionnaires. We used multiple linear regressions to assess association with sociodemographic, lifestyle, psychosocial, and disease-related factors. RESULTS Altogether 1656 patients completed the questionnaires (905 Crohn's disease and 751 ulcerative colitis/IBD unclassified). Only 91 (5.7%) of patients had an effort-reward imbalance ratio >1. Effort-reward imbalance and OC scores were higher in full-time versus part-time employees (coef = 0.050, P = 0.002; coef = 0.906, P < 0.001) and among those absent from the workplace in the previous 3 months (coef = 0.049, P = 0.010; coef = 1.062, P < 0.001). Higher OC scores were associated with sex (women vs. men: coef = 0.568, P = 0.014), being in a relationship (coef = 0.805, P = 0.001), higher level of occupation (director vs. trainee: coef = 1.447, P < 0.001), and extraintestinal manifestations (coef = 0.623, P = 0.005). Patients hospitalized in the previous 12 months had lower OC scores (coef = 0.560, P = 0.038). CONCLUSIONS The average level of job stress seems to be remarkably low in patients with IBD from Switzerland. The clinician should turn attention especially to women, full-time employees with a high level of education, and patients with extraintestinal manifestations to identify those with the most vulnerability to suffer from job stress.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Determinants of Job Stress in Patients with Inflammatory Bowel Disease

Schreiner

Biedermann

Rossel

et al. 2017

Inflammatory Bowel Diseases

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“…In patients of cardiovascular disease, several stressors have also been strongly related to cardiovascular endpoints, such as recurrent events and mortality. [61][62][63][64] In general, strong associations are less likely to be confounded than weak associations. For example, the 4.7-fold excess risk of cardiac event during anger outburst 60 could be explained away only if an unmeasured confounder was associated with both stress and cardiac event by as large hazard ratio as 9.0; a weaker uncontrolled confounding could not do so (Figure 2).…”

Section: Scale Of the Problemmentioning

confidence: 99%

Effects of stress on the development and progression of cardiovascular disease

2017

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Cardiovascular disease remains the leading cause of disease burden globally, which underlies the continuing need to identify new complementary targets for prevention. Over the past 5-10 years, the pooling of multiple data sets into 'mega-studies' has accelerated progress in research on stress as a risk and prognostic factor for cardiovascular disease. Severe stressful experiences in childhood, such as physical abuse and household substance abuse, can damage health and increase the risk of multiple chronic conditions in adulthood. Compared with childhood stress and adulthood classic risk factors, such as smoking, high blood pressure, and high serum cholesterol levels, the harmful effects of stress in adulthood are generally less marked. However, adulthood stress has an important role as a disease trigger in individuals who already have a high atherosclerotic plaque burden, and as a determinant of prognosis and outcome in those with pre-existing cardiovascular or cerebrovascular disease. In real-life settings, mechanistic studies have corroborated earlier laboratory-based observations on stress-related pathophysiological changes that underlie triggering, such as lowered arrhythmic threshold and increased sympathetic activation with related increases in blood pressure, as well as pro-inflammatory and procoagulant responses. In some clinical guidelines, stress is already acknowledged as a target for prevention for people at high overall risk of cardiovascular disease or with established cardiovascular disease. However, few scalable, evidence-based interventions are currently available.

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“…Little is known about the role of work stress in the development of recurrent CVD events in patients who remain employed after their first CVD. According to a recent meta-analysis based on five papers derived from four cohort studies, work stress ( as measured by either the JDC model or the ERI model) in employees with CVD was associated with a 65% excess risk to develop recurrent CVD events 30) . However, a recent study did not con-firm those previous findings, indicating that work stress was not associated with recurrent CVD events 31 ) .…”

Section: Step 4: Work Stress Increases the Risk Of Recurrent Cvd In Wmentioning

confidence: 99%

Work stress and cardiovascular disease: a life course perspective

Loerbroks

Bosma

et al. 2016

Journal of Occupational Health

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Individuals in employment experience stress at work, and numerous epidemiological studies have documented its negative health effects, particularly on cardiovascular disease (CVD). Although evidence on the various interrelationships between work stress and CVD has been accumulated, those observations have not yet been conceptualized in terms of a life course perspective. Using the chain of risk model, we would like to propose a theoretical model incorporating six steps: (1) work stress increases the risk of incident CVD in healthy workers. (2) Among those whose work ability is not fully and permanently damaged, work stress acts as a determinant of the process of return to work after CVD onset. (3) CVD patients experience higher work stress after return to work. (4) Work stress increases the risk of recurrent CVD in workers with prior CVD. (5) CVD patients who fully lose their work ability transit to disability retirement. (6) Disability retirees due to CVD have an elevated risk of CVD mortality. The life course perspective might facilitate an in-depth understanding of the diverse interrelationships between work stress and CVD, thereby leading to work stress management interventions at each period of the lifespan and three-level prevention of CVD.

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Work stress and the risk of recurrent coronary heart disease events: A systematic review and meta-analysis

Cited by 75 publications

References 65 publications

Prevalence and Determinants of Job Stress in Patients with Inflammatory Bowel Disease

Prevalence and Determinants of Job Stress in Patients with Inflammatory Bowel Disease

Effects of stress on the development and progression of cardiovascular disease

Work stress and cardiovascular disease: a life course perspective

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