Work-Related Stress Linked to Poor Cardiovascular Health in US Adults

A new cross-sectional analysis linked work-related stress to an unfavorable impact on cardiovascular health (CVH) among a multi-ethnic community-based adult population free from cardiovascular disease (CVD).¹

In the analysis, involving 3579 men and women aged 45 to 84 years, participants reporting work-related stress were less likely to exhibit average or optimal CVH scores based on the American Heart Association (AHA) Life's Simple 7 metrics. Life’s Simple 7 metrics include smoking, physical activity, body mass index (BMI), diet, total cholesterol, blood pressure, and blood glucose.

“To address the public health issue of work-related stress and its detrimental effects on cardiovascular health, future research should prioritize the use of longitudinal studies to identify the mechanisms underlying this association,” said investigators Oluseye Ogunmoroti, MD, MPH, Emory University and Erin Michos, MD, MHS, Johns Hopkins University.²

Work-related stress is characterized by detrimental physical and emotional responses from an imbalance between work requirements and a person’s capabilities, resources, or needs. Estimates suggest that 10-40% of workers experience work-related stress and a subsequent elevated risk of adverse CVD outcomes, particularly coronary heart disease (CHD).³

Citing the dearth of literature on the correlation between work-related stress and the construct of CVD, Ogunmoroti and colleagues sought to estimate the link between work-related stress and unfavorable CVH in a racially and ethnically diverse sample of adults without known CVD.¹

Baseline data on 6814 adults free from clinical CVD were obtained between 2000 and 2002 in the Multi-Ethnic Study of Atherosclerosis. The final analytic sample was 3579 after participants with missing observations for variables of interest, retired participants, and unemployed participants were excluded from study.

A self-administered questionnaire evaluated the presence of work-related stress at baseline. Each of Life’s Simple 7 metrics conibuted 0, 1, or 2 points depending on the poor, intermediate, or ideal range, respectively. Aggregated CVH scores were 0 to 14 points, ranging from inadequate (0–8), average (9–10), and optimal (11–14).

A polytomous logistic regression model estimated the independent link between work-related stress and CVH, adjusted for sociodemographic factors, including age, sex, race and ethnicity, and health insurance status. The mean age of participants was 57 years and 48% were women.

Overall, 20% of the study population reported work-related stress—these participants were more commonly younger, women, and White. Compared with participants without work-related stress, those with work-related stress exhibited a lower likelihood of average and optimal CVH scores (odds ratio [OR], 0.75 [95% CI, 0.62–0.92] and OR, 0.73 [95% CI, 0.58–0.92], respectively).

In particular, patients with work-related stress had lower odds of having the ideal physical activity (OR, 0.70 [95% CI, 0.56–0.86]), with similar direction of association between work-related stress and ideal metrics for smoking, BMI, diet, total cholesterol, blood pressure, and blood glucose, although the CIs included the null.

Supplemental analyses revealed no findings of effects by age (<65 versus ≥65 years), sex, or race and ethnicity. Further research found the presence of work-related stress for ≥6 months was linked to a lower likelihood of favorable CVH.

Based on these data, Ogunmoroti and colleagues highlighted the critical nature of workplace wellness programs to manage stress and promote CVH. They called for further research to establish a definitive causal link between work-related stress and unfavorable CVH.

“Conducting thorough workplace intervention studies is essential for the development and implementation of effective stress management strategies that can enhance employee well-being and improve cardiovascular health,” Ogunmoroti and Michos added.²

References

1. _{Ogunmoroti O, Osibogun O, Allen NB, et al. Work-Related Stress Is Associated With Unfavorable Cardiovascular Health: The Multi-Ethnic Study of Atherosclerosis. J Am Heart Assoc. Published online November 6, 2024. doi:10.1161/JAHA.124.035824}
2. _{Work stress increases risk of unfavorable cardiovascular health measures. News. November 6, 2024. Accessed November 6, 2024. https://www.news-medical.net/news/20241106/Work-stress-increases-risk-of-unfavorable-cardiovascular-health-measures.aspx.}
3. _{Tsao CW, Aday AW, Almarzooq ZI, et al. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association [published correction appears in Circulation. 2023 Feb 21;147(8):e622. doi: 10.1161/CIR.0000000000001137] [published correction appears in Circulation. 2023 Jul 25;148(4):e4. doi: 10.1161/CIR.0000000000001167]. Circulation. 2023;147(8):e93-e621. doi:10.1161/CIR.0000000000001123}