Risk Of A Second Heart Attack Doubled With Chronic Job Strain

Main Category: Heart Disease
Also Included In: Anxiety / Stress;  Psychology / Psychiatry
Article Date: 10 Oct 2007 - 2:00 PST

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People who experience chronic job strain after a first heart attack double their risk of suffering from a second one, reports a research team from Universite Laval's Faculty of Medicine in the October 10 issue of the Journal of the American Medical Association.

This study is the first to clearly demonstrate the risks associated with job strain for workers who have been victim of a first heart attack. Research had previously shown a relationship between work-related stress and a first coronary heart disease (CHD) event, but studies examining job strain and recurrent CHD were few, limited in scope, and inconsistent in their findings.

The research team supervised by Chantal Brisson followed a group of 972 participants, ages 35 to 59, who had suffered a heart attack. These people were interviewed six weeks, two years, and then six years after returning to work in order to collect data on their health, lifestyles, sociodemographic status, and levels of work stress A job was defined as stressful if it combined high psychological demands (heavy workload, intense intellectual activity, and important time constraints) and little control over decision-making (lack of autonomy, creativity, and opportunities to use or develop skills).

During the six-year follow-up period, 124 participants suffered a second heart attack and 82 experienced unstable angina for a total of 206 recurrent CHD events. People who had reported high levels of stress at work during the first two interviews were twice as likely to fall victim to another CHD event. The risk remained the same even after taking into account factors such as severity of the first heart attack, other health conditions, family history, lifestyle, sociodemographic status, personality, and other work-environment characteristics.

The study shows that during the first two years following a heart attack, job strain does not increase the probability of experiencing a second CHD event. "It make sense on a biomedical level, since the pathological process at the source of the CHD requires some time before it can manifest itself," comments Brisson.

Researchers insist on the importance of disseminating the results of this study in the workplace, so as to protect people from potentially harmful situations when they return to their jobs after a heart attack. "Employers and occupational health service professionals must find ways to modify the psychological demands of a job or the level of control over decision-making for people returning to work after a heart attack," suggests Brisson. "It can be done, and encouraging autonomy, creativity, and the development of professional abilities in the workplace is not incompatible with a company's productivity," concludes the researcher.

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In addition to Brisson, the study was co-authored by Corine Aboa-Éboulé, Elizabeth Maunsell, Renée Bourbonnais, Michel Vézina, Alain Milot, Gilles Dagenais, Benoît Mâsse, and Pierre Théroux.

Information:
Michel Vézina
Chantal Brisson
Faculty of Medicine
Université Laval

Source: Jean-François Huppé
Université Laval

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