Combination of job strain, high efforts, and low rewards doubled the risk of heart disease in men

Men who say they have stressful jobs and also feel they exert high efforts for low reward had double the risk of heart disease compared to men free of those stressors, according to new research published in Circulation: Cardiovascular Quality and Outcomes, a peer-reviewed American Heart Association journal.

Research has shown that two psychosocial stressors — job strain and effort-reward imbalance at work — may increase heart disease risk. However, few studies have examined the combined effect.

Study’s lead author Lavigne-Robichaud explained, “Job strain refers to work environments where employees face a combination of high job demands and low control over their work. High demands can include a heavy workload, tight deadlines and numerous responsibilities, while low control means the employee has little say in decision-making and how they perform their tasks.”

“Effort-reward imbalance occurs when employees invest high effort into their work, but they perceive the rewards they receive in return — such as salary, recognition or job security — as insufficient or unequal to the effort. For instance, if you’re always going above and beyond, but you feel like you’re not getting the credit or rewards you deserve, that’s called effort-reward imbalance.”

The study found:

Men who said they experienced either job strain or effort-reward imbalance had a 49% increase in risk of heart disease compared to men who didn’t report those stressors.

Men reporting both job strain and effort-reward imbalance were at twice the risk of heart disease compared with men who did not say they were experiencing the combined stressors.

The impact of psychosocial stress at work on women’s heart health was inconclusive.

In men, the impact of job strain and effort-reward imbalance combined was similar to the magnitude of the impact of obesity on the risk of coronary heart disease.

Reference: Psychosocial Stressors at Work and Coronary Heart Disease Risk in Men and Women:18-Year Prospective Cohort Study of Combined Exposures, Circulation Cardiovascular Quality and Outcomes, DOI 10.1161/CIRCOUTCOMES.122.009700