Work stress causes 68% more premature deaths in men with cardiometabolic disease

Work stress is six times more likely to kill men than women who exhibit cardiometabolic disease despite otherwise being healthy, according to a new study published June 5 in The Lancet: Diabetes & Endocrinology.

“The finding that job strain increases mortality risk, even in subgroups of men with cardiometabolic disease but a favorable cardiometabolic risk profile, suggests that standard care targeting conventional risk factors is unlikely to mitigate the mortality risk associated with job strain,” wrote lead author Mika Kivimaki, PhD, of the University College London, and colleagues.

The researchers sought to better understand stress as a risk factor in cardiometabolic disease by assessing the associations between work stress and mortality in men and women with and without pre-existing cardiometabolic disease.

They used the health data of more than 102,000 individuals from the U.K., Sweden, Finland and France, 3,441 of whom exhibited cardiometabolic disease at the start of the study. The cohort was given a questionnaire assessing demographics, smoking habits, alcohol consumption and physical activity.

The cohort’s medical records were tracked for an average of almost 14 years. They found 3,841 individuals died during follow up.

The study rated work stress in two different ways. The first was defined as “job strain,” or having a demanding job without control over those demands. The second was “effort-reward imbalance,” or putting a lot of effort into their job without seeing much reward.

The researchers found men who exhibited cardiometabolic disease and had met their health targets, who also had job strain, experienced a 68 percent higher rate of premature death than those without job strain. They found the effort-reward imbalance group had no risk.

They found no association between work stress and premature death for women with or without cardiometabolic disease.

“Subsequent research should employ intervention designs to establish whether systematic screening and management of work stressors such as job strain would contribute to improved health outcomes in men with coronary heart disease, stroke or diabetes,” Kivimaki and colleagues concluded.