A Cross - Sectional Analysis of The Association of Job Strain with Metabolic Syndrome and 10-Year Risk of Coronary Heart Disease

Abstract

Objective: Beside the well-established biological and behavioral risk factors, psychosocial factors have been accepted as important risk factors for coronary heart diseases CHD . While there is abundant evidence for the association between job strain and CHD in developed countries, more research needed on this association in developing countries. This study aims to examine the association between job strain and the risk of CHD and metabolic syndrome among the 30–64-year-old employed individuals.Methods: This is a population-based cross-sectional study. The study sample was derived randomly from the employed individuals aged between 30 and 64 participated in baseline Balcova Heart Study. Karasek’s demand-control-support questionnaire was applied to measure job strain. Presence of metabolic syndrome and Framingham risk score were main dependent variables. 191 female and 216 male participants were included in the analyses. Pearson chi-square test, ANCOVA and logistic regression analyses were used.Results: Women were found to have higher education levels, have more white-collar jobs, and have better economic status perception than men. 20% of men and 18% of women have been working in high-strain jobs. There was significant association of job strain with neither the Framingham risk score nor metabolic syndrome. The adjustments for education, age, and occupation did not alter the results. The interaction between the social support and job strain was also not significant.Conclusion: Job strain did not have an impact on both the Framingham risk score and metabolic syndrome. Although psychosocial factors are known as important risk factors for CHD in developed countries, the evidence in developing countries is scarce

Keywords

• job strain,coronary heart disease,metabolic syndrome,social support

References

1. Roth GA, Johnson C, Abajobir A, et al. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J Am Coll Cardiol 2017;70:1–25. [CrossRef]
2. Marmot MG, Elliott P. Coronary heart disease epidemiology: from aetiology to public health. USA: Oxford University Press; 2005. Published to Oxford Scholarship Online: September 2009. [CrossRef]
3. Dinc G, Sozmen K, Gerceklioglu G, Arik H, Critchley J, Unal B. Decreasing trends in cardiovascular mortality in Turkey between 1988 and 2008. BMC Public Health 2013;13:896. [CrossRef]
4. Kawachi I. Stress and the Heart: Psychosocial Pathways to Coronary Heart Disease. BMJ 2002;324:176. [CrossRef]
5. Steptoe A, Marmot M. The role of psychobiological pathways in socio-economic inequalities in cardiovascular disease risk. Eur Heart J 2002;23:13–25. [CrossRef]
6. Demiral Y. Çalışma yaşamında psikososyal etmenler [Psychosocial factors at work]. Mesleki Sağlık ve Güvenlik Dergisi [Turkish journal of occupational health and safety] 2005;20:22–26.
7. Karasek RA, Theorell TG, Schwartz J, Pieper C, Alfredsson L. Job, psychological factors and coronary heart disease. In: Denolin H, editor. Psychological Problems before and after Myocardial Infarction. Basel: Karger Publishers; 1982. pp.62–67.
8. Karasek RA. The demand-control-support model and CVD. In: Schnall PL, Belkic K, Landsbergis P, Baker D, editors. The Workplace and Cardiovascular Disease, First ed. Philadelphia, PA: Hanley and Belfus; 2000. p.78–85.

9. Xu S, Huang Y, Xiao J, et al. The association between job strain and coronary heart disease: a meta-analysis of prospective cohort studies. Ann Med 2015;47:512–518. [CrossRef]
10. Pan KY, Xu W, Mangialasche F, Fratiglioni L, Wang HX. Work-related psychosocial stress and the risk of type 2 diabetes in later life. J Intern Med 2017;281:601–610. [CrossRef]
11. Huang YL, Xu SX, Hua JH, et al. Association between job strain and risk of incident stroke A meta-analysis. Neurology 2015;85:1648– 1654. [CrossRef]
12. Babu GR, Jotheeswaran AT, Mahapatra T, et al. Is hypertension associated with job strain? A meta-analysis of observational studies. Occup Environ Med 2014;71:220–227. [CrossRef]
13. Fishta A, Backe EM. Psychosocial stress at work and cardiovascular diseases: an overview of systematic reviews. Int Arch Occup Environ Health 2015;88:997–1014. [CrossRef]
14. Garcia-Rojas IJ, Choi B, Krause N. Psychosocial job factors and biological cardiovascular risk factors in Mexican workers. Am J Ind Med 2015;58:331–351. [CrossRef]
15. Demiral Y, Soysal A, Can Bilgin A, et al. The association of job strain with coronary heart disease and metabolic syndrome in municipal workers in Turkey. J Occup Health 2006;48:332–338. [CrossRef]
16. Ergor G, Soysal A, Sozmen K, et al. Balcova heart study: rationale and methodology of the Turkish cohort. Int J Public Health 2012;57:535– 542. [CrossRef]
17. Grundy SM, Brewer HB, Jr., Cleeman JI, Smith SC, Lenfant C. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 2004;109:433–438. [CrossRef]
18. Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998;97:1837–1847. [CrossRef]
19. Unal B, Sozmen K, Ucku R, et al. High prevalence of cardiovascular risk factors in a Western urban Turkish population: a community- based study. Anadolu Kardiyol Derg 2013;13:9–17. [CrossRef]
20. D’Agostino RB Sr, Vasan RS, Pencina MJ, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 2008;117:743–753. 10.1161/CIRCULATIONAHA.107.69957
21. Lynch J, Davey Smith G, Harper S, Bainbridge K. Explaining the social gradient in coronary heart disease: comparing relative and absolute risk approaches. J Epidemiol Community Health 2006;60:436–441. [CrossRef]
22. Nyberg ST, Fransson EI, Heikkila K, et al. Job strain and cardiovascular disease risk factors: meta-analysis of individual-participant data from 47, 000 men and women. PLoS ONE 2013;8:e67323. [CrossRef]
23. Edwards EM, Stuver SO, Heeren TC, Fredman L. Job strain and incident metabolic syndrome over 5 years of follow-up: the coronary artery risk development in young adults study. J Occup Environ Med 2012;54:1447–1452. [CrossRef]
24. Chandola T, Brunner E, Marmot M. Chronic stress at work and the metabolic syndrome: prospective study. BMJ 2006;332:521–525. [CrossRef]
25. Steptoe A, Kivimaki M. Stress and cardiovascular disease: an update on current knowledge. Annu Rev Public Health 2013;34:337–354. [CrossRef]
26. Belkic KL, Landsbergis PA, Schnall PL, Baker D. Is job strain a major source of cardiovascular disease risk? Scand J Work Environ Health 2004;30:85–128. [CrossRef]
27. Xu W, Yu H, Gao W, Guo L, Zeng L, Zhao Y. When job stress threatens Chinese workers: combination of job stress models can improve the risk estimation for coronary heart disease--the BADCAR study. J Occup Environ Med 2011;53:771–775. [CrossRef]
28. Christensen KB, Labriola M, Lund T, Kivimaki M. Explaining the social gradient in long-term sickness absence: a prospective study of Danish employees. J Epidemiol Community Health 2008;62:181–183. [CrossRef]
29. Bosma H, Marmot MG, Hemingway H, Nicholson AC, Brunner E, Stansfeld SA. Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study. BMJ 1997;314:558–565. [CrossRef]
30. Kuper H, Marmot M. Job strain, job demands, decision latitude, and risk of coronary heart disease within the Whitehall II study. J Epidemiol Community Health 2003;57:147–153. [CrossRef]