[Job strain and heart rate variability. New evidence and new prospects]

Work stress has been associated with an increased risk for cardiovascular disease. Two major pathways capable to explain the link between job stress and the cardiovascular diseases have been extensively studied: the hypothalamic-pituitary-adrenal axis and the autonomic nervous system (ANS). The analysis of heart rate variability (HRV) has been proposed to assess the regulation of the ANS. Several studies established that HRV reduction is a strong and independent predictor of mortality in patients with various cardiovascular diseases. However the assessment of HRV can also be used as a non-invasive tool to predict cardiovascular events in healthy subjects. The aim of this paper is to review and report the results of main studies assessing the association between JS and HRV. Up to now a limited number of studies assessing the relationship between working conditions and HRV has been published. In the majority of them, higher levels of JS has been found associated with lower values of HRV. The literature suggests that HRV analysis can be a valid indicator of JS effects on the cardiovascular system. For the future studies are necessary longitudinal cohorts studies appropriately selected, to obtain information about the cardiovascular effects of prolonged JS.