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Job stress and coronary heart disease: a case-control study using a Chinese population

Weixian Xu1, Yiming Zhao, Lijun Guo

  • 1Department of Cardiology, Peking University Third Hospital and Key Laboratory of Molecular Cardiovascular Science, Ministry of Education.

Journal of Occupational Health
|January 31, 2009
PubMed

Insights

Job stress, measured by the effort-reward imbalance (ERI) model, significantly elevates coronary heart disease (CHD) risk in Chinese adults. High ERI and overcommitment markedly increase CHD risk, while high reward offers protection.

Area of Science:

  • Cardiology
  • Occupational Health
  • Psychosocial Epidemiology

Background:

  • Coronary heart disease (CHD) remains a leading cause of mortality globally.
  • The role of psychosocial factors, such as job stress, in CHD development requires further investigation, particularly in diverse populations.

Purpose of the Study:

  • To investigate the association between job stress, assessed using the effort-reward imbalance (ERI) model, and the risk of coronary heart disease (CHD).
  • To determine if job stress is an independent risk factor for CHD in a Chinese population, beyond traditional risk factors.

Main Methods:

  • A case-control study involving 388 participants (30-70 years) undergoing coronary angiography.
  • 292 CHD cases and 96 controls were analyzed.
  • Job stress was quantified using the effort-reward imbalance (ERI) model, assessing extrinsic effort and overcommitment.

Main Results:

  • High ERI, high extrinsic effort, and high overcommitment were associated with significantly increased CHD risk (ORs 2.8-2.8) after adjusting for traditional risk factors.
  • The combination of high ERI and high overcommitment yielded the highest CHD risk (adjusted OR 5.5).
  • High reward demonstrated a protective effect, reducing CHD risk (adjusted OR 0.4) compared to low reward; dose-response relationships were observed.

Conclusions:

  • Job stress, as evaluated by the ERI model, is a significant risk factor for CHD in the Chinese population.
  • Job stress may independently contribute to CHD development, irrespective of established traditional risk factors.
  • Effort-reward imbalance and overcommitment are key components of job stress that elevate CHD risk.
Abstract

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