The influence of burnout on cardiovascular disease: a systematic review and meta-analysis
Awena John1, Jean-Baptiste Bouillon-Minois2, Reza Bagheri3
1Université Clermont Auvergne, CHU Clermont-Ferrand, Occupational Medicine, Clermont-Ferrand, France.
Insights
Burnout significantly elevates cardiovascular disease risk by 21%, particularly prehypertension. Further research is needed to confirm causality and develop workplace preventive strategies for burnout and cardiovascular health.
Area of Science:
- Public Health
- Occupational Health
- Cardiology
Background:
- Burnout is a recognized public health issue with potential cardiovascular implications.
- Cardiovascular disease (CVD) risk associated with burnout is under investigation.
- This study systematically reviews and meta-analyzes the link between burnout and CVD.
Approach:
- A systematic review and random-effect meta-analysis was conducted.
- Searched major databases (PubMed, PsycINFO, Cochrane, Embase, ScienceDirect) for studies reporting CVD risk post-burnout.
- Analyzed 25 studies (9 in meta-analysis, 26,916 participants), stratifying by CVD type and adjusting for confounders.
Key Points:
- Burnout increased overall CVD risk by 21% (OR=1.21) using adjusted models.
- Significant risk increases observed for prehypertension (85%) and CVD hospitalization (10%).
- No significant risk increase for coronary heart disease or myocardial infarction; results consistent across adjusted and crude analyses.
Conclusions:
- Burnout appears to elevate cardiovascular disease risk, though causality is limited by study design.
- Further research into the pathophysiology of burnout-related CVD risk is warranted.
- Findings suggest potential for developing workplace preventive strategies targeting burnout and cardiovascular health.
Background:
Burnout is a public health problem with various health consequences, among which cardiovascular disease is the most investigated but still under debate. Our objective was to conduct a systematic review and meta-analysis on the influence of burnout on cardiovascular disease.
Methods:
Studies reporting risk (odds ratio, relative risk, and hazard ratio) of cardiovascular disease following burnout were searched in PubMed, PsycINFO, Cochrane, Embase, and ScienceDirect. We performed a random-effect meta-analysis stratified by type of cardiovascular disease and searched for putative influencing variables. We performed sensitivity analyses using the most adjusted models and crude risks.
Results:
We included 25 studies in the systematic review and 9 studies in the meta-analysis (4 cross-sectional, 4 cohort, and 1 case-control study) for a total of 26,916 participants. Burnout increased the risk of cardiovascular disease by 21% (OR = 1.21, 95% CI 1.03 to 1.39) using the most adjusted risks and by 27% (OR = 1.27, 95% CI 1.10 to 1.43) using crude risks. Using stratification by type of cardiovascular disease and the most adjusted risks, having experienced burnout significantly increased the risk of prehypertension by 85% (OR = 1.85, 95% CI 1.00 to 2.70) and cardiovascular disease-related hospitalization by 10% (OR = 1.10, 95% CI 1.02 to 1.18), whereas the risk increase for coronary heart disease (OR = 1.79, 95% CI 0.79 to 2.79) and myocardial infarction (OR = 1.78, 95% CI 0.85 to 2.71) was not significant. Results were also similar using crude odds ratio. The risk of cardiovascular disease after a burnout was not influenced by gender. Insufficient data precluded other meta-regressions.
Conclusions:
Burnout seems to increase the risk of cardiovascular disease, despite the few retrieved studies and a causality weakened by cross-sectional studies. However, numerous studies focused on the pathophysiology of cardiovascular risk linked to burnout, which may help to build a preventive strategy in the workplace.
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