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The association between effort-reward imbalance and coronary atherosclerosis in a Chinese sample
Weixian Xu1, Yiming Zhao, Lijun Guo
1Department of Cardiology, Peking University Third Hospital and Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, People's Republic of China.
Insights
High job stress, measured by effort-reward imbalance (ERI), significantly increases coronary heart disease (CHD) risk and lesion complexity in Chinese workers. Further research is needed to confirm mechanisms for CHD prevention.
Area of Science:
- Occupational Health
- Cardiovascular Disease Epidemiology
- Psychosocial Factors in Health
Background:
- Previous research on job strain and coronary heart disease (CHD) yielded inconsistent results.
- The effort-reward imbalance (ERI) model is a key framework for evaluating job stress.
Purpose of the Study:
- To investigate the association between job stress, using the ERI model, and coronary atherosclerosis.
- To assess coronary artery stenosis in a Chinese population sample.
Main Methods:
- A cohort of 320 participants undergoing their first coronary angiography was studied.
- Job stressors were assessed using the ERI model.
- Coronary artery stenosis (>50% luminal stenosis) determined CHD presence and severity; multivariate analysis examined associations.
Main Results:
- High effort, overcommitment, and ERI were linked to a 2.4-2.5 fold increased CHD risk.
- These stressors correlated positively with the complexity of coronary artery lesions.
- Observed dose-response relationships indicated increasing risk with higher stress levels.
Conclusions:
- The effort-reward imbalance (ERI) is associated with coronary artery lesions in Chinese workers.
- Further longitudinal and interventional studies are recommended to elucidate mechanisms and inform CHD prevention strategies.
Background:
Previous studies of job strain and coronary heart disease (CHD) have produced mixed findings. We aimed to examine the association between job stress evaluated by the effort-reward imbalance (ERI) model and coronary atherosclerosis assessed by coronary angiography in a Chinese sample.
Methods:
Three-hundred twenty participants accepting coronary angiography for the first time were enrolled in series. Job stressors were evaluated by the ERI model. The presence and severity of CHD were assessed by measuring the coronary artery stenosis (the presence of >50% luminal stenosis in one or more major coronary arteries). The association between job stressors and CHD was examined by multivariate analysis.
Results:
Compared with the low-level group, high-level effort, overcommitment, and ERI increased CHD risk with odds ratio (OR) 2.5 (95% confidence interval (CI): 1.2-5.0), 2.5 (95% CI: 1.2-5.0), 2.4 (95% CI: 1.2-4.9), respectively, after adjustment for confounders. They were also significantly positively correlated with the complexity of coronary artery lesions, respectively. Dose-response relationships were observed.
Conclusions:
ERI was associated with coronary artery lesions in a sample of Chinese workers. Longitudinal research and interventional designs are needed to confirm the mechanism and to provide evidence for the prevention of CHD.
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