Work Stress Plays Huge Role in Heart Disease

Fri, 4 Nov. 2011 - 9:12 p.m. MT
Credit: ARA Staff - American Running Association

Like headache, stress affects nearly all of us at one time or another. But somewhat astonishing results unleashed in November on the relationship between work stress and cardiovascular disease offer us greater insight and even a call to action to reduce workplace stress. Of course, eating right and exercising are the two basic principles by which readers of Running & FitNews® attempt to live; they are essential components to a healthy life. But how many of us choose to ignore work-related stress, brushing it off as inevitable, ubiquitous, and less directly consequential to our health?
Presented at an American Heart Association meeting, findings from the landmark Harvard Women’s Health Study, an ongoing and extremely detailed inquiry into disease prevention involving more than 17,000 female health professionals, show that women whose work is highly stressful have a 40% increased risk of heart disease. While these findings are certainly a wake-up call that most immediately affect how women evaluate and manage work-related stress, this unsettling percentage could reasonably hold true or be similarly high for men—if indeed it doesn’t turn out to be even higher.
The researchers looked at incidents of myocardial infarction, the need for coronary artery surgery, hypertension, cholesterol level, and obesity, and found strong links to various indicators of job stress, including fear of job loss. The study used a definition of job strain that combined psychological demand with degree of control. “Demand” referred to the amount, pace, and difficulty of the work. “Control” meant the ability to make work-related decisions or be creative at work. The dangerous combination in terms of cardiovascular health was high demand and little control.
Though the role stress plays in diminishing health is well documented, it is yet unclear exactly how job strain causes cardiac problems. The stress may aggravate inflammation in coronary arteries, leading to blood clots that can trigger a heart attack. Stress also makes it harder to practice heart-healthy habits, such as exercise, a good diet, not smoking, and adequate sleep. It’s hard to tell what proportion of heart attack risk is due to psychological stress as opposed to, say, smoking or lack of exercise. Certainly, job stress accounts for a great deal of overall stress, if only because Americans spend so much time at work.
But internationally, the evidence mounts as well. A large 15-year study of nurses in Denmark concluded that the greater the work pressure, the higher the risk for heart disease among women ages 51 and under. In a third study, this time of white-collar workers of both genders in Beijing, job strain was associated in women with increased thickness of the carotid artery wall, an early sign of cardiovascular disease. Notably, this effect was not found in men. It will be interesting to see how patterns play out globally as more evidence presents itself.
In the meantime, it is quite clear that in order to protect heart health and reduce the risk of cardiovascular incidents, job stress—and stress outside the workplace—must be reduced. We are programmed to react to life-threatening stress with a cascade of brain-triggered chemicals and hormones that speed the heart rate, quicken breathing, increase blood pressure, and boost the amount of glucose supplied to muscles. The body does a poor job of discriminating between grave, imminent dangers and less momentous ongoing sources of stress, such as financial difficulties, job strain, and even worries about potential problems that haven’t yet arisen. When the fight-or-flight response is chronically in the “on” position, the body suffers.
It is compelling to frame stress within the context of excessive demands and too little control, because in so doing the researchers help us see stressors outside the workplace as well. If that one-two punch of confounding factors is the essence of stress, modern humans may begin to see it nearly everywhere.
Many people, perhaps most often women, have multiple concurrent jobs. Caring for children or for aging parents while running a household and working outside the home is a common scenario for many people who often simply do not have the resources to manage it. Situations like this may be unavoidable. Still, let’s not take that to mean that all is beyond our control:
1. Look to other relationships with people to provide emotional support and to ease your burden, and thereby your feelings of isolation, if any. In turn, look for small ways that you can support others; the benefits of helping another person include feeling empowered, and like we all make a difference.
2. Regular exercise is good for your heart, reduces anxiety and depression, improves sleep, and is recreational and social.
3. Practice relaxation techniques such as meditation, deep breathing, progressive     relaxation, or visualization.
4. Adopt a pet. Studies repeatedly show that regular interaction with a dog or cat can significantly reduce stress (see “Your Pet and Your Health” in this issue).
4. If you’re feeling overwhelmed, seek help from a mental health professional.
AHA Meeting Report, “Women with High Job Strain Have 40 Percent Increased Risk of Heart Disease,” Nov., 2010,
Health Beat, Feb., 2011, “Women, Work, Stress, and Heart Disease: 5 Ways to Protect Yourself,”

(RUNNING & FITNEWS® January / February 2011 • Volume 29, Number 1)

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