Journal Article

Does Job Strain Increase the Risk for Coronary Heart Disease or Death in Men and Women?

Elaine D. Eaker, Lisa M. Sullivan, Margaret Kelly-Hayes, Ralph B. D’Agostino and Emelia J. Benjamin

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 159, issue 10, pages 950-958
Published in print May 2004 | ISSN: 0002-9262
Published online May 2004 | e-ISSN: 1476-6256 | DOI:
Does Job Strain Increase the Risk for Coronary Heart Disease or Death in Men and Women?

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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.

Keywords: cohort studies; coronary disease; occupations; psychology; stress; Abbreviations: CHD, coronary heart disease; CI, confidence interval; RR, relative risk.

Journal Article.  6021 words.  Illustrated.

Subjects: Public Health and Epidemiology

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