Job stress and carotid intima-media thickness in Chinese workers

Carotid intima-media thickness (CIMT) can be used as a surrogate marker for cardiovascular health, and job stress is a risk factor for cardiovascular disease. However, there have been a limited number of studies focusing on the association between job stress and CIMT. The goal of this study was to explore the association between job stress and CIMT in a Chinese working population.

The study included 734 participants (508 males and 226 females) without coronary heart disease. Job stress was evaluated using the effort-reward imbalance (ERI) questionnaire at work. ERI is the ratio between efforts and rewards (weighted by number of items). High resolution carotid ultrasonographic studies were performed using a Sequoia 512 ultrasound system with an 8-13 MHz linear array transducer to assess CIMT.

This study detected gender-specific associations between the indictors of the ERI model and increased CIMT among the study participants in China. This study demonstrated a robust association in women between the key indicators of ERI, effort, overcommitment and ERI, and increased CIMT (adjusted r(2)=0.258, p=0.001; adjusted r(2)=0.261; p<0.001; adjusted r(2)=0.274; p<0.001, respectively). Reward was inversely correlated with CIMT (adjusted r(2)=0.282, p<0.001), controlling for age, hypertension, diabetes mellitus, hyperlipidaemia and body mass index. For men, a similar pattern of associations was observed, but the associations were lost after adjustment for confounders.

Our results show that effort, overcommitment and ERI may be associated with early atherosclerosis predicted by CIMT in women, and reward is inversely related to CIMT.