Hard work puts stress on the female heart

By Piriya Mahendra

Women who have stressful jobs may be putting themselves at increased risk for a cardiovascular (CV) event a decade down the line, researchers say.

Women who were classified as having 'high-strain' jobs, defined as roles where they are under high demand and have low control, and 'active' jobs, defined as roles where they are under high demand and have high levels of control, had a 38% higher risk for a 10-year CV event than women with low job strain - low demand and high control.

"From a clinical perspective, it may be useful for health professionals to screen patients for psychosocial stressors and to connect individuals to resources for healthy stress management," comment Michelle Albert (Harvard Medical School, Boston, Massachusetts, USA) and team in PLoS One.

They found that 23.8% of the 22,086 women studied had low job strain, while 34.4% had passive jobs (defined as low demand and low control), 21.4% had active jobs, and 20.4% had high job strain.

Job demand encompassed pace, challenge, amount of work, time to complete work, and conflicting demands. Job control comprised decision authority and skill discretion.

Adjustment for age, race, study-drug assignment, education, and income showed that women with high job strain had a 67% higher risk for myocardial infarction (MI) and a 41% higher risk for coronary revascularization than women who reported having low job strain.

Albert et al note that depressive/anxious symptoms explained the highest proportion of the observed association between high job strain and CV risk, at 21%, compared with other traditional CV risk factors including hypertension (5%), Type 2 diabetes (1%), and family history of MI (2%).

Previous analyses of predominantly male populations have supported a link between job stress and incident CV events. Until now, the evidence for a similar association in women has been unclear.

However, contrary to previous studies in men, the current study showed no statistically significant association between job insecurity and 10-year CV risk.

Nonetheless, job insecurity was still associated with risk factors for CV disease, including smoking, physical inactivity, hypertension, diabetes, hypercholesterolemia, and body mass index in bivariate analysis.

"These results suggest that women with high strain and active jobs experience long-term vascular effects where high demand appears to be the critical factor," remark the authors.

"Our findings suggest the need to develop interventions to improve psychosocial characteristics of the work environment since this may have long-term benefits for CV health in women," Albert and team conclude.

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