Am J Epidemiol 2004; 159:950-958.
Copyright © 2004 by the Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Does Job Strain Increase the Risk for Coronary Heart Disease or Death in Men and Women?
The Framingham Offspring Study
1 Eaker Epidemiology Enterprises, LLC, Chili, WI.
2 Department of Mathematics and Statistics, Boston University School of Public Health, Boston, MA.
3 The National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, MA.
4 Departments of Neurology and Cardiology, Boston University School of Medicine, Boston, MA.
5 Department of Cardiology, Boston University School of Medicine, Boston, MA.
Conflicting findings in the literature have made the relation between job strain and coronary heart disease (CHD) controversial. The effect of high job strain on the 10-year incidence of CHD and total mortality was examined in men and women participating in the Framingham Offspring Study; 3,039 participants, 1,711 men and 1,328 women, aged 18–77 years, were examined between 1984 and 1987 and followed for 10 years. Measures of job strain, occupational characteristics, and risk factors for CHD were collected at the baseline examination. Before and after controlling for systolic blood pressure, body mass index, cigarette smoking, diabetes, and the total/high density lipoprotein cholesterol ratio in Cox proportional hazards models, the authors found that high job strain was not associated with mortality or incident CHD in either men or women over the follow-up period. Contrary to expectation, women with active job strain (high demands-high control) had a 2.8-fold increased risk of CHD (95% confidence interval: 1.1, 7.2) compared with women with high job strain (high demands-low control). For men, higher education, personal income, and occupational prestige were related to decreased risk of total mortality and CHD. These findings do not support high job strain as a significant risk factor for CHD or death in men or women.
cohort studies; coronary disease; occupations; psychology; stress
Abbreviations: Abbreviations: CHD, coronary heart disease; CI, confidence interval; RR, relative risk.
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