A Potent Combination: Dual Stress Factors Amplify Heart Disease Risk in Men

According to an 18-year research study focusing on white-collar professionals, jobs that are stressful and perceived as offering low rewards can elevate the risk of heart disease in men by a factor of two. These results underscore the imperative for more salubrious work settings.

The study identifies job strain and high efforts paired with low rewards as individual psychosocial stress factors associated with an increased risk of heart disease. When combined, these factors pose a particularly escalated risk for men.

Men who experience stressful work conditions and also perceive that their efforts are met with low rewards were found to have double the risk of developing heart disease in contrast to men who did not report these stress factors. This combined impact was akin to the effect of obesity on the risk of coronary heart disease, based on the study’s evaluation of nearly 6,500 white-collar employees in Canada. The research did not draw conclusive results regarding the impact of work stress on women’s cardiac health.

The findings were published on September 19 in the peer-reviewed journal Circulation: Cardiovascular Quality and Outcomes by the American Heart Association.

Mathilde Lavigne-Robichaud, R.D., M.S., the principal study author and doctoral candidate at the Population Health and Optimal Health Practices Research Unit at CHU de Quebec-University Laval Research Center in Quebec, Canada, emphasized that “Given the substantial amount of time people invest in their jobs, comprehending the nexus between work-related stress and cardiovascular health is essential for both public health and employee well-being.” Lavigne-Robichaud stressed that there is an urgent need to address these workplace stressors to cultivate healthier work environments that benefit both employees and employers.

Heart Disease: A Preeminent Health Risk

According to statistics from the American Heart Association, heart disease remains the leading cause of mortality in the United States. Nearly 383,000 American citizens succumbed to heart disease in the year 2020 alone.

While individual research projects have previously identified job strain and effort-reward imbalance as stress factors that elevate heart disease risk, few have investigated their combined impact.

In detailing the stressors, Lavigne-Robichaud elucidated that “Job strain characterizes workplaces where employees encounter a blend of high job demands and limited control over their duties. Effort-reward imbalance transpires when employees exert significant effort in their tasks but perceive the rewards, such as salary or recognition, to be insufficient or disproportionate.”

Principal Research Outcomes

Key findings from the study include:

• Men who reported experiencing either job strain or effort-reward imbalance saw a 49% rise in heart disease risk compared to men who did not report these stress factors.
• Men who reported both stress factors faced a twofold risk of heart disease.
• The research could not conclusively determine the impact of these stress factors on women’s cardiac health.

Lavigne-Robichaud concluded, “Our data propose that interventions aimed at mitigating workplace stress could be particularly advantageous for men and may also yield benefits for women, as such stressors are linked with other widespread health issues such as depression.”

Potential Strategies and Wider Implications

Potential interventions might include resource support, work-life balance promotion, better communication, and empowerment of employees in their roles, according to Lavigne-Robichaud.

Dr. Eduardo J. Sanchez, M.D., M.P.H., FAHA, FAAFP, the Chief Medical Officer for Prevention at the American Heart Association, stated, “The American workforce is among the most stressed globally, and these work-related stressors can have health impacts equivalent to obesity and secondhand smoke exposure. This research amplifies the growing body of evidence that workplaces should be prioritized for cardiovascular health improvement initiatives.”

Research Specifics

• The study followed almost 6,500 white-collar employees with an average age of approximately 45, who were initially free of heart disease, for a period of 18 years from 2000 to 2018.
• The cohort included 3,118 men and 3,347 women working in a diverse range of roles in Quebec, Canada.
• Established health databases were used to retrieve information on heart disease, and validated questionnaires were utilized to measure job strain and effort-reward imbalance.

One limitation of the study is its focus on white-collar employees primarily in Quebec, Canada, which may not fully represent the diverse American working population. Nevertheless, the findings could be applicable to white-collar employees in the United States and other high-income nations with comparable job structures, according to Lavigne-Robichaud.

Reference: “Psychosocial Stressors at Work and Coronary Heart Disease Risk in Men and Women: 18-Year Prospective Cohort Study of Combined Exposures” by Mathilde Lavigne-Robichaud et al., 19 September 2023, Circulation: Cardiovascular Quality and Outcomes.
DOI: 10.1161/CIRCOUTCOMES.122.009700

Frequently Asked Questions (FAQs) about Heart Disease Risk and Workplace Stress

More about Heart Disease Risk and Workplace Stress

• American Heart Association Statistics on Heart Disease
• Circulation: Cardiovascular Quality and Outcomes Journal
• CHU de Quebec-University Laval Research Center
• Understanding Job Strain
• Psychosocial Stressors at Work
• Effort-Reward Imbalance and Health
• Workplace Interventions for Stress Reduction