Lack of job may raise heart attack risk

By Piriya Mahendra, medwireNews Reporter

Unemployment, multiple job losses, and short periods without work are all significant risk factors for acute myocardial infarction (AMI), say researchers.

They also found that the elevated risks associated with multiple job losses were similar in magnitude to those associated with more traditional cardiovascular disease (CVD) risk factors, such as smoking, Type 2 diabetes, and hypertension.

"In the context of the current US economy and projected increases in job instability and unemployment among workers, additional studies should investigate the mechanisms contributing to work-related disparities in AMI to identify viable targets for successful interventions," write Matthew Dupre (Duke University Medical Center, Durham, North Carolina, USA) and team.

They found that the risk for AMI was a significant 35% higher among the 1883 unemployed people in the study than the 9924 employed people. Moreover, the risk for AMI increased incrementally by 22% for individuals who had lost one job to 63% for individuals who had lost four or more jobs.

The authors note in the Archives of Internal Medicine that the risk for AMI was particularly elevated (at 27%) within the first year of unemployment but not thereafter.

Although the magnitude of the hazard ratios for AMI was greater for men, Hispanic people, and non-Hispanic Black people than for women and non-Hispanic White people, these associations were not statistically significant.

Editorialist William Gallo (City University of New York, USA) explains that a number of factors, including financial difficulty, social withdrawal, behavioral changes, elevated cortisol levels, and chronic anxiety, may be involved in the mechanism underlying unemployment-associated CVD risk.

"Although employment background is not amenable to medical intervention, knowledge about employment status, number of job losses, and the amount of time unemployed may help to identify individuals at elevated risk for AMI," say Dupre and team.

Gallo adds: "The next generation of studies should identify reasonable pathways from job separation to illness so that nonoccupational interventions may be developed and targeted to the most vulnerable individuals."

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