Saturday, October 19, 2002
(Oct. 18) -
Investigators found that people who reported persistent stress due to high work demands, low job security, or few career opportunities had the same level of risk for fatal heart attacks as people who smoke and do not exercise. High job stress was also associated with being overweight and having high cholesterol.
"We don't really know if the increased risk for [heart disease] death is due to physiological changes in the body that occur in response to chronic stress or because stress may be a predictor of poorer overall health habits," says lead researcher Mika Kivimaki, PhD, of the University of Helsinki.
While acknowledging that stress management benefits overall health, the American Heart Association (AHA) says there is little direct evidence that stress reduction is effective for the prevention or treatment of heart disease.
AHA spokesman Philip Greenland, MD, tells WebMD that the twofold increase in heart disease deaths reported in this study is modest compared to the increases associated with the big three risk factors for heart disease -- smoking, high blood pressure, and high cholesterol. Research suggests that people who have all three risk factors are 16 times more likely to die from heart disease as those who have none.
"It is quite possible that job strain could contribute to heart disease, but in the absence of these three major risk factors we are not talking about a really big impact," says Greenland, who leads the department of preventive medicine at Chicago's Northwestern University.
"I am concerned that this will be interpreted as meaning that dealing with stress is all you have to do. You can't ignore these other risk factors."
In this study, Kivimaki and colleagues followed more than 800 workers -- men and women -- at a metal-works factory in Finland for an average of 25 years in an attempt to examine the relationship between work and stress. None of the participants had heart disease when the study began, but 73 people had died from heart disease by the time it ended. The study is reported in the Oct. 19 issue of the British Medical Journal.
After taking into account obvious heart attack risk factors such as age, smoking, high blood pressure, being overweight, and sedentary lifestyle, the researchers found that employees who reported high job strain were twice as likely to die from heart disease as workers who did not feel stressed. Workers who felt they had high work demands, little opportunity for advancement, and a feeling that their work was not rewarding were also twice as likely to die of heart disease.
"We have known that stress is something that can trigger heart attacks in people who already have heart disease," Kivimaki tells WebMD. "But this study suggests it is a risk factor that can predict [heart disease death] in anyone."
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