Who doesn’t feel stressed out at work these days?
Indeed, according to a national survey taken earlier this year, 83 percent of Americans say their jobs are stressful — up from 73 percent in 2012.
Poor compensation and unreasonable workloads led the list of the survey participants’ work-related stressors, followed by frustration with co-workers or commutes, working in an unfulfilling or dead-end job, poor work-life balance, and fear of being fired or laid off.
Although the evidence is only indirect, some research has suggested that a stressful work environment — job strain — is associated with an increased risk of heart disease. This association has been found in both men and women and in people of all ages and across all socioeconomic groups.
Working conditions are a major contributor to job stress — and one, unfortunately, that many employees can’t do anything about, at least on their own. But individual employees can take personal actions that may reduce at least some of the negative effects of job-related stress on their heart. For a study published Monday in the Canadian Medical Association Journal (CMAJ) reports that a healthy lifestyle — defined as not being sedentary, obese, a smoker or an excessive drinker — can significantly lower the risk of heart disease among people with job strain.
In fact, the study found that among people who reported job strain, those with an unhealthy lifestyle were twice as likely to develop heart disease within a 10-year period as those who had a healthy lifestyle.
This may seem like a “duh” study, but previous research has been unclear on whether lifestyle factors could actually mitigate the adverse effects of work-related stress on the heart.
Seven pooled studies
The new study, a meta-analysis, pooled data from seven studies involving more than 102,000 people, aged 17 to 70, in five European countries (the United Kingdom, France, Belgium, Sweden and Finland). At the start of the studies, all the participants were free of heart disease. Almost 16,000 of them (16 percent) reported job strain.
Based on information provided through questionnaires, the researchers divided the participants into three lifestyle categories: healthy (no lifestyle risk factors for heart disease), moderately unhealthy (one risk factor) and unhealthy (two to four risk factors). As already noted, those lifestyle risk factors were 1) current smoking, 2) physical inactivity, 3) heavy drinking (21 or more alcoholic drinks per week for women and 18 or more for men), and 4) obesity (a body mass index of 30 or greater).
Over 10 years, people with a healthy lifestyle were significantly less likely to develop heart disease (12.0 per 1,000) than those with an unhealthy lifestyle (30.6 per 1,000).
Among people with job strain, the incidence rates were higher, but had a similar spread. The incidence of heart disease among people with job strain and a healthy lifestyle was 14.7 per 1,000 compared to 31.2 per 1,000 among those with job strain and an unhealthy lifestyle — or 53 percent lower.
This meta-analysis comes with caveats, of course. Participants self-reported their lifestyle habits, and the results are observational and therefore cannot prove direct cause-and-effect.
Still, “these observational data suggest that a healthy lifestyle could substantially reduce the risk of coronary artery disease among people with job strain,” the authors of the meta-analysis conclude. “In addition to stress counseling, clinicians might consider paying closer attention to lifestyle risk factors in patients who report job strain.”
The rest of us will want to pay closer attention as well.
The study can be read in full on the CMAJ website.