Work-related stress linked to poor cardiovascular health

New research highlights the impact of workplace stress on heart health and underscores the need for wellness interventions.

Study: Work‐Related Stress Is Associated With Unfavorable Cardiovascular Health: The Multi‐Ethnic Study of Atherosclerosis. Image Credit: PeopleImages.com – Yuri A/Shutterstock.com

In a recent study published in the Journal of the American Heart Association, researchers investigated the association between work-related stress and cardiovascular health (CVH) in a multiethnic sample of adults free of cardiovascular disease (CVD) at baseline.

Background 

In 2010, the American Heart Association introduced a new definition of CVH emphasizing primordial prevention of CVD risk factors through the assessment of seven health behaviors and factors known as Life’s Simple 7: smoking, physical activity, diet, total cholesterol, body mass index (BMI), blood pressure, and blood glucose.

In 2022, this was updated to Life’s Essential 8 with the addition of sleep. High levels of psychosocial stress, particularly work-related stress, negatively impact CVH and increase the risk of adverse CVD outcomes.

Further research is needed to explore the relationship between work-related stress and CVH across diverse populations.

About the study

Data for this analysis were sourced from the Multi‐Ethnic Study of Atherosclerosis (MESA). Baseline data were collected from 6,814 participants, aged 45 to 84, who were free of clinical CVD or heart failure. The diverse cohort comprised approximately 38% White, 28% Black, 22% Hispanic, and 12% Chinese American individuals.

Work-related stress was assessed via a self-administered questionnaire, with participants reporting ongoing job-related difficulties. CVH was evaluated using the American Heart Association’s Life’s Simple 7 metrics, which encompass factors such as smoking status, physical activity, BMI, dietary habits, and blood pressure.

The study considered various sociodemographic covariates, including age, sex, education, race, and income, to analyze the independent association between work-related stress and CVH. Statistical analyses utilized polytomous logistic regression models to estimate odds ratios (OR), adjusting for potential confounders. 

Study results 

The study sample comprised 3,579 participants, of whom 48% were women, with a mean age of 57 years and a standard deviation of 8 years. Those reporting work-related stress tended to be younger, with a larger proportion under the age of 65 compared to their counterparts who did not experience work-related stress.

Additionally, a greater percentage of women reported experiencing work-related stress in contrast to men, highlighting a potential gender difference in the prevalence of this psychosocial risk factor.

Among racial and ethnic groups, White participants exhibited a higher prevalence of work-related stress than other groups, while Chinese American and Hispanic participants showed a lower proportion of work-related stress when compared to their non-stressed counterparts.

The analysis revealed significant associations between work-related stress and CVH scores. Participants experiencing work-related stress had notably lower odds of attaining both average and optimal CVH scores.

Specifically, those with work-related stress were less likely to achieve scores that reflect healthy cardiovascular metrics, indicating that stress related to work may be detrimental to cardiovascular well-being.

Furthermore, the presence of work-related stress was linked to reduced odds of meeting the criteria for multiple ideal metrics. This suggests that individuals experiencing work-related stress may struggle to engage in health-promoting behaviors or maintain optimal health indicators.

When examining individual CVH metrics, participants with work-related stress were less likely to report ideal levels of physical activity.

Although a similar trend was observed across other health behaviors such as smoking, BMI, diet, total cholesterol levels, blood pressure, and blood glucose, the confidence intervals for these associations included the null value, indicating that these findings were not statistically significant.

This highlights the complexity of the relationship between work-related stress and various aspects of CVH, as stress’s influence may manifest differently across individual health metrics.

The supplemental analyses conducted did not indicate any effect measure modification based on age, sex, or race and ethnicity, suggesting that the negative impact of work-related stress on CVH may be consistent across different demographic groups.

Furthermore, the analysis revealed that sustained work-related stress for six months or more was associated with a further decline in CVH, emphasizing the long-term implications of chronic stress on cardiovascular outcomes.

Conclusions

To summarize, in the multiethnic cohort of adults without CVD, those experiencing work-related stress showed lower odds of favorable CVH scores and fewer ideal CVH metrics compared to those without stress.

This association was evident in physical activity levels and mirrored trends in smoking, BMI, diet, and other health factors. Biological mechanisms, such as elevated cortisol and epinephrine, may contribute to inflammation and poor CVH.