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Psychosocial work conditions before myocardial infarction in young men
Insights
Young men surviving myocardial infarction (heart attack) face risks from high LDL/HDL cholesterol, smoking, and specific work demands. Low alcohol intake also predicted heart attack risk in this group.
Area of Science:
- Cardiology
- Occupational Health
- Psychosocial Medicine
Background:
- Myocardial infarction (MI) in young men is a significant health concern.
- Understanding risk factors beyond traditional medical markers is crucial for prevention.
- The interplay of medical and psychosocial factors in early-onset MI requires further investigation.
Purpose of the Study:
- To identify medical and psychosocial risk factors associated with myocardial infarction (MI) in men under 45.
- To explore the correlation between psychosocial variables and the severity of coronary atherosclerosis.
Main Methods:
- A case-control study involving male patients who survived MI before age 45 and matched male controls.
- Assessment of medical risk factors including coronary atherosclerosis via angiography.
- Evaluation of psychosocial risk factors, including work-related demands and lifestyle, 3-6 months post-MI.
Main Results:
- No correlation was found between psychosocial variables and the degree of coronary atherosclerosis.
- Excessive work demands, particularly lack of variety and intellectual discretion, were more prevalent in MI patients.
- Independent predictors for MI included high LDL/HDL cholesterol ratio, high cumulative tobacco consumption, high work variety demands, high work influence demands, and low alcohol consumption.
Conclusions:
- Specific occupational psychosocial factors, alongside traditional medical and lifestyle factors, are significant predictors of MI in young men.
- While excessive work demands alone did not predict MI, their interaction with other factors like variety and influence is important.
- Targeting high-risk individuals based on a combination of lipid profiles, smoking history, work environment, and alcohol consumption may aid in preventing early-onset MI.
Abstract:
All male patients in the greater Stockholm area who had survived a myocardial infarction below the age of 45 were examined with regard to medical and psychosocial risk factors 3-6 months after the onset of the infarction. For each patient, a male control subject was randomly selected after matching with regard to age and residence area. In the patient group, coronary angiograms were performed and rated with regard to degree of coronary atherosclerosis. The psychosocial variables were not correlated with degree of coronary atherosclerosis. Excessive work demands combined with boredom at work ("variety" and "intellectual discretion") were significantly more often reported by the patients after adjustment had been made for life style factors. In the multivariate analysis a high LDL/HDL cholesterol ratio, a high cumulative tobacco consumption, high demands in relation to variety at work as well as high demands in relation to influence over work and finally a low alcohol consumption were significant independent predictors of case status. Excessive work demands in themselves did not differentiate cases from controls.