Coronary microvascular function in male physicians with burnout and job stress: an observational study
Roland von Känel1, Mary Princip2, Sarah A Holzgang2
1Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091, Zurich, Switzerland. roland.vonkaenel@usz.ch.
Insights
Physician burnout and job stress are linked to coronary microvascular dysfunction, increasing cardiovascular risk. Understanding these work-related factors is crucial for physician heart health.
Area of Science:
- Cardiology
- Occupational Health
- Psychosomatic Medicine
Background:
- Physicians face high burnout and job stress, elevating coronary heart disease risk.
- Coronary microvascular dysfunction predicts major adverse cardiovascular events.
- This study investigates the link between physician burnout, job stress, and coronary microvascular function.
Purpose of the Study:
- To examine the association between burnout and job stress with coronary microvascular function in male physicians.
- To determine if these work-related factors predict cardiovascular events through microvascular pathways.
Main Methods:
- Thirty male physicians with burnout and 30 controls were assessed using the Maslach Burnout Inventory and effort-reward imbalance/overcommitment questionnaires.
- Myocardial perfusion positron emission tomography quantified endothelium-dependent and -independent coronary microvascular function.
- Regression analyses adjusted for age and BMI examined burnout and job stress in relation to coronary flow reserve.
Main Results:
- Burnout and job stress were significantly associated with endothelium-dependent microvascular function.
- Burnout positively correlated with coronary flow reserve and myocardial blood flow.
- High effort-reward imbalance and overcommitment showed inverse associations with microvascular function measures.
Conclusions:
- Burnout and high job stress exhibit opposing associations with coronary microvascular endothelial function in male physicians.
- Further longitudinal research is needed to clarify clinical implications and temporal relationships.
- Incorporating burnout and job stress assessments is vital for a comprehensive understanding of cardiovascular health in physicians.
Background:
As a professional group, physicians are at increased risk of burnout and job stress, both of which are associated with an increased risk of coronary heart disease that is at least as high as that of other professionals. This study aimed to examine the association of burnout and job stress with coronary microvascular function, a predictor of major adverse cardiovascular events.
Methods:
Thirty male physicians with clinical burnout and 30 controls without burnout were included. Burnout was assessed with the Maslach Burnout Inventory and job stress with the effort-reward imbalance and overcommitment questionnaire. All participants underwent myocardial perfusion positron emission tomography to quantify endothelium-dependent (cold pressor test) and endothelium-independent (adenosine challenge) coronary microvascular function. Burnout and job stress were regressed on coronary flow reserve (primary outcome) and two additional measures of coronary microvascular function in the same model while adjusting for age and body mass index.
Results:
Burnout and job stress were significantly and independently associated with endothelium-dependent microvascular function. Burnout was positively associated with coronary flow reserve, myocardial blood flow response, and hyperemic myocardial blood flow (r partial = 0.28 to 0.35; p-value = 0.008 to 0.035). Effort-reward ratio (r partial = - 0.32 to - 0.38; p-value = 0.004 to 0.015) and overcommitment (r partial = - 0.30 to - 0.37; p-value = 0.005 to 0.022) showed inverse associations with these measures.
Conclusions:
In male physicians, burnout and high job stress showed opposite associations with coronary microvascular endothelial function. Longitudinal studies are needed to show potential clinical implications and temporal relationships between work-related variables and coronary microvascular function. Future studies should include burnout and job stress for a more nuanced understanding of their potential role in cardiovascular health.
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