Job stress leads to heart issues among women: study

In some instances, risk rises by 70%

Job stress is as hard on a woman’s heart as it is on a man’s, a large new study has found.

The study of more than 22,000 women who were monitored for 10 years found that those who held highly demanding jobs, with the power and authority to make major decisions, had an almost 40-per-cent increased risk of having a heart attack, stroke, bypass surgery or other cardiovascular “event” over the follow-up period compared with women with low job strain.

For women with demanding jobs but little decisionmaking power or the ability to be creative, the risk of heart attack increased by nearly 70 per cent.

Cardiovascular disease is the leading cause of death for women and men in Canada.

Mounting research is linking chronic psychosocial stress – including stress related to work, finances and home – with a higher heart attack and stroke risk. But the data on women are sparse and remain “way behind” the data for men, said lead author Dr. Michelle Albert, a cardiologist at Brigham and Women’s Hospital in Boston and associate professor at Harvard Medical School.

For its study, the team explored the relationship between job strain and job insecurity and cardiovascular disease among 22,086 apparently healthy nurses, doctors and other female health professionals who participated in the Women’s Health Study – initially a trial testing Aspirin and vitamin E for the prevention of heart disease and cancer.

Women were grouped into four categories: passive job strain (low demand and low control jobs), active (high demand and high control, which would typically include executives, managers, teachers and physicians), low strain (low demand and high control), or high strain (high demand and low control, such as waitresses or assembly line workers).

During 10 years of followup, there were 170 heart attacks, 163 strokes, 440 revascularizations – procedures such as angioplasty to bypass or unblock coronary arteries – and 52 deaths from cardiovascular disease.

Women who belonged to the “active” and “high strain” groups had a 38-per-cent higher risk of stroke, heart attacks, cardiovascular death and heart surgery.

Only about one-quarter of the increased risk could be explained by the usual risk factors, such as high blood pressure, diabetes, smoking, high cholesterol or depression.

Chronic stress repeatedly activates the body’s autonomic nervous system, our innate “fight or flight” response. Evidence suggests that people exposed to chronic stress have heightened inflammation throughout their body, “which is associated with all different types of chronic illness, including coronary artery disease,” Albert said. They also pro- duce more cortisol, a stress hormone that affects insulin sensitivity and body weight.

The researchers didn’t find a link between job insecurity and increased risk of heart attack or stroke – but women who reported feeling insecure about their jobs were more likely to smoke, have high blood pressure and a higher body weight, increasing their risk of cardiovascular disease in the long term.

Given the “dramatic” increase in women in the workforce, Albert said the findings highlight the need to address job stress in any prevention efforts aimed at lowering cardiovascular disease among women.