Job strain and incident cardiovascular disease: the confounding and mediating effects of lifestyle habits. An overview of systematic reviews

Riopel, Camille; Lavigne-Robichaud, Mathilde; Trudel, Xavier; Milot, Alain; Gilbert-Ouimet, Mahée; Talbot, Denis; Aubé, Karine; Brisson, Chantal

doi:10.1080/19338244.2020.1828244

Cited by 5 publications

(3 citation statements)

References 35 publications

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“…Adjustment was performed sequentially to avoid effect underestimation due to statistical control for potential mediators. 31 Validated instruments were used to assess job strain and ERI while combined exposure allowed for a precise differentiation of risk levels. Finally, marginal effect measures were estimated, representing the average effect on the population, facilitating the public health interpretation of our results.…”

Section: Discussionmentioning

confidence: 99%

“…Adjustment for potential confounders was performed using inverse probability weights (IPW) of confounding 30 and distinguishing between common confounders and potential mediators. 31 Cox models were sequentially adjusted for each subgroup of cofactors. First, a crude model was constructed, with sex stratification and age adjustment through timescale.…”

Section: Discussionmentioning

confidence: 99%

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Psychosocial Stressors at Work and Coronary Heart Disease Risk in Men and Women: 18-Year Prospective Cohort Study of Combined Exposures

Lavigne-Robichaud,

Trudel,

Talbot

et al. 2023

Circ: Cardiovascular Quality and Outcomes

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Background. Psychosocial stressors at work, like job strain and effort-reward imbalance (ERI), can increase coronary heart disease (CHD) risk. ERI indicates an imbalance between the effort and received rewards. Evidence about the adverse effect of combined exposure to these work stressors on CHD risk is scarce. This study examines the separate and combined effect of job strain and ERI exposure on CHD incidence in a prospective cohort of white-collar workers in Quebec, Canada. Methods. Six thousand four hundred sixty-five white-collar workers without cardiovascular disease (mean age, 45.3±6.7) were followed for 18 years (from 2000 to 2018). Job strain and ERI were measured with validated questionnaires. CHD events were retrieved from medico-administrative databases using validated algorithms. Marginal Cox models were used to calculate hazard ratios (HR) stratified by sex. Multiple imputation and inverse probability weights were applied to minimize potential threats to internal validity. Results. Among 3118 men, 571 had a first CHD event. Exposure to either job strain or ERI was associated with an adjusted 49% CHD risk increase (HR, 1.49 [95% CI, 1.07–2.09]). Combined exposure to job strain and ERI was associated with an adjusted 103% CHD risk increase (HR, 2.03 [95% CI, 1.38–2.97]). Exclusion of early CHD cases and censoring at retirement did not alter these associations. Among 3347 women, 265 had a first CHD event. Findings were inconclusive (passive job HR, 1.24 [95% CI, 0.80–1.91]; active job HR, 1.16 [95% CI, 0.70–1.94]; job strain HR, 1.08 [95% CI, 0.66–1.77]; ERI HR, 1.02 [95% CI, 0.72–1.45]). Conclusions. In this prospective cohort study, men exposed to job strain or ERI, separately and in combination, were at increased risk of CHD. Early interventions on these psychosocial stressors at work in men may be effective prevention strategies to reduce CHD burden. Among women, further investigation is required.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Psychosocial Stressors at Work and Coronary Heart Disease Risk in Men and Women: 18-Year Prospective Cohort Study of Combined Exposures

Lavigne-Robichaud,

Trudel,

Talbot

et al. 2023

Circ: Cardiovascular Quality and Outcomes

Self Cite

View full text Add to dashboard Cite

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“…Psychosocial work stressors can lead to CVD through direct activation of neuroendocrine stress pathways (see Figure 16.1, arrows G, J, L-P), but also indirectly through health behaviors such as smoking, heavy alcohol use, unhealthy diet, physical inactivity, and sleeping problems (arrows H, K, N-P; Chandola et al, 2008;Niedhammer et al, 2022;O'Connor et al, 2021;Riopel et al, 2021). Therefore, adjusting for health behaviors in analysis may underestimate the total effect of work stressors on CVD (Choi et al, 2015;Riopel et al, 2021). Smoking prevalence and intensity have been associated in cross-sectional studies with job strain and its components (Mattsson et al, 2021;Nyberg et al, 2013;Rugulies et al, 2008) as well as with ERI (Siegrist & Rödel, 2006).…”

Section: Work Stressors and Cvd Behavioral Risk Factorsmentioning

confidence: 99%

Occupational psychosocial factors and cardiovascular disease.

Landsbergis,

García-Rivas,

Juárez-García

et al. 2024

Handbook of Occupational Health Psychology (3rd Ed.).

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C ardiovascular disease (CVD) is the leading cause of death globally, representing 32% of all deaths (World Health Organization [WHO], 2021a), and a major contributor to disability (Roth et al., 2020). Hypertension (high blood pressure), the leading cause of CVD globally (Roth et al., 2020), affects an estimated 1.28 billion adults aged 30 to 79 years worldwide, two thirds living in low-and middle-income countries (WHO, 2021b). Other CVD risk factors, including obesity, diabetes, and metabolic syndrome, have also become global epidemics (Virani et al., 2021). However, inadequate attention has been paid to occupational risk factors for CVD, particularly psychosocial factors and workplace-based interventions and policy, which we discuss in this chapter. This chapter updates our previous, more comprehensive reviews (Landsbergis et al., 2017;Schnall et al., 2016Schnall et al., , 2017.Decades of research have enabled us to formulate a social-ecological model of occupational psychosocial factors and CVD, including social determinants of health; political, economic, social, labor market, and workplace-level risk factors; and biopsychosocial mechanisms (see Figure 16.1). We first discuss recent trends in CVD and work-related risk factors, then we review the risk factors at various levels of our model, intervention research, and recommendations for research and policy.

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Adverse Effect of Psychosocial Stressors at Work and Long Working Hours Along the Cardiovascular Continuum

Trudel

Ouimet

Milot

et al. 2023

Handbook Series in Occupational Health Sciences

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Job strain and incident cardiovascular disease: the confounding and mediating effects of lifestyle habits. An overview of systematic reviews

Cited by 5 publications

References 35 publications

Psychosocial Stressors at Work and Coronary Heart Disease Risk in Men and Women: 18-Year Prospective Cohort Study of Combined Exposures

Psychosocial Stressors at Work and Coronary Heart Disease Risk in Men and Women: 18-Year Prospective Cohort Study of Combined Exposures

Occupational psychosocial factors and cardiovascular disease.

Adverse Effect of Psychosocial Stressors at Work and Long Working Hours Along the Cardiovascular Continuum

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