Does Work Stress Lead to Heart Disease?

It seems logical that stress, and in particular job-related stress, where we spend so much of our time and effort, would contribute to health issues. So many of my patients report that they have had "a lot of issues at work" in the same breath as their description of chest pain-type symptoms. And there is that urban myth about people working so hard that it resulted in their demise. But most of these myths often have a kernel of truth and recently, a group of British researchers performed an analysis of 13 studies performed between 1985-2006 assessing job strain as a risk factor for coronary heart disease, i.e. heart attacks.

Of the nearly 200,000 patients analyzed, 15% reported significant job strain and after some savvy statistical analysis that involves terms like hazard ratios and reverse causality, these smart guys found that job stress does indeed appear to be linked with higher rates of heart attacks. Their interpretation as described in the published abstract stated the following:

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.

 

So, those of you smoking to deal with a tough day of work - cut it out! The smoking will hurt you way more than your distasteful boss.

 

The American Heart Association is not as confident in linking stress to heart disease and bluntly states on their website that...  "although stress is not a confirmed risk factor for either high blood pressure or heart disease, and has not been proven to cause heart disease, scientists continue to study how stress relates to our health. And while blood pressure may increase temporarily when you're stressed, stress has not been proven to cause chronic high blood pressure."

 

The AHA then goes on to give several recommendations for how to manage stress in your life (some good, some not that good) which you can find here:

 

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Stress-and-Blood-Pressure_UCM_301883_Article.jsp

 

In my opinion, stress contributes more to mental anguish and anxiety than anything else and often triggers our coping mechanisms - which may be good (e.g. exercise, reading, yoga, etc) or more often bad (smoking, drinking, festering, etc). The key is to try to minimize the bad coping mechanisms, avoid situations that are stressful if possible, and enjoy life.

 

The Lancet, Volume 380, Issue 9852, Pages 1491 - 1497, 27 October 2012