Lancet：工作压力大导致心脏病风险升高

9月14日英国医学刊物《柳叶刀》刊登论文说，工作压力大的人群出现心脏病的风险会更高，因此人们如果能想办法减轻工作压力，有助改善健康。

一个国际研究小组调查了比利时、丹麦、芬兰、法国、荷兰、瑞典和英国这7个欧洲国家中近20万人的健康资料，分析结果显示，那些工作压力较大的人，与其他人比起来出现心脏病的风险要高出23%。这里的工作压力大是指工作对人的要求较高，并且缺少对工作内容的决定权的情况。

领导这项研究的伦敦大学学院教授米卡·基维迈基说，分析显示工作压力与心脏病风险之间存在联系，即使在考虑了目标群体的年龄、性别、经济状况、生活方式等因素并随之进行计算调整后，这种联系是仍然存在的。因此，如果能想办法降低工作压力，将有助于减少人们的患病风险。

有专家指出，这项研究中所涉及的工作压力只是实际工作环境对人们精神状态造成影响的一部分，人们可能还会面临工作是否稳定和失业风险等方面的问题，因此实际生活中工作压力带来的心脏病风险也许会比本次研究得出的结果更高。

拓展阅读：

   BMJ：夜间工作者患心血管疾病风险大

   JNNP：慢性压力或导致中风风险升高

   女性职场压力过大可能增加患糖尿病风险

   Nat Med：揭示压力和抑郁导致大脑萎缩机制

   超七成公务员压力大健康堪忧

doi:10.1016/S0140-6736(12)60994-5
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Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data

Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data

Background

Published work assessing psychosocial stress (job strain) as a risk factor for coronary heart disease is inconsistent and subject to publication bias and reverse causation bias. We analysed the relation between job strain and coronary heart disease with a meta-analysis of published and unpublished studies.

Methods

We used individual records from 13 European cohort studies (1985—2006) of men and women without coronary heart disease who were employed at time of baseline assessment. We measured job strain with questions from validated job-content and demand-control questionnaires. We extracted data in two stages such that acquisition and harmonisation of job strain measure and covariables occurred before linkage to records for coronary heart disease. We defined incident coronary heart disease as the first non-fatal myocardial infarction or coronary death.

Findings

30 214 (15%) of 197 473 participants reported job strain. In 1·49 million person-years at risk (mean follow-up 7·5 years [SD 1·7]), we recorded 2358 events of incident coronary heart disease. After adjustment for sex and age, the hazard ratio for job strain versus no job strain was 1·23 (95% CI 1·10—1·37). This effect estimate was higher in published (1·43, 1·15—1·77) than unpublished (1·16, 1·02—1·32) studies. Hazard ratios were likewise raised in analyses addressing reverse causality by exclusion of events of coronary heart disease that occurred in the first 3 years (1·31, 1·15—1·48) and 5 years (1·30, 1·13—1·50) of follow-up. We noted an association between job strain and coronary heart disease for sex, age groups, socioeconomic strata, and region, and after adjustments for socioeconomic status, and lifestyle and conventional risk factors. The population attributable risk for job strain was 3·4%.

Interpretation

Our findings suggest that prevention of workplace stress might decrease disease incidence; however, this strategy would have a much smaller effect than would tackling of standard risk factors, such as smoking.

Funding

Finnish Work Environment Fund, the Academy of Finland, the Swedish Research Council for Working Life and Social Research, the German Social Accident Insurance, the Danish National Research Centre for the Working Environment, the BUPA Foundation, the Ministry of Social Affairs and Employment, the Medical Research Council, the Wellcome Trust, and the US National Institutes of Health.