Job strain and major risk factors for coronary heart disease among employed males and females in a Swedish study on work, lipids and fibrinogen.
OBJECTIVE
The aim of this study was to analyze the relationship of job strain (high psychological job demands and low decision latitude) to hypertension, serum lipids, and plasmafibrinogen.


METHODS
The study population consisted of employed persons between the ages of 15 and 64 years in the counties of Stockholm, Västernorrland, and Jämtland, Sweden. The data collection was carried out during 1992-1998. A total of 10,382 subjects participated in a medical examination and completed a questionnaire.


RESULTS
No strong associations were found between job strain and plasma fibrinogen. The males reporting job strain had lower levels of total cholesterol and high-density lipoprotein cholesterol than the other males. Similar tendencies were found for the females. The females, but not the males, with job strain had an increased prevalence of hypertension when compared with the subjects with relaxed psychosocial work characteristics. In the subgroups of younger males and females an adverse association between job strain and the ratio between low-density and high-density lipoprotein cholesterol was noted.


CONCLUSIONS
The results do not support the hypothesis that job strain has an adverse impact on serum total cholesterol and plasma fibrinogen levels. They suggest that an increased risk of coronary heart disease in association with job strain, if causal, is mediated by other factors, possibly partly by hypertension and low levels of high-density lipoprotein cholesterol.
Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. lars.alfredsson@imm.ki.se
Lars
L
Alfredsson
Niklas
N
Hammar
Eleonor
E
Fransson
Ulf
U
de Faire
Johan
J
Hallqvist
Anders
A
Knutsson
Tohr
T
Nilsson
Töres
T
Theorell
Peter
P
Westerholm
D000293:Adolescent; D000328:Adult; D002784:Cholesterol / Q000097:blood / Q000145:classification; D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D003430:Cross-Sectional Studies; D004651:Employment / Q000523:psychology*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000523:psychology; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
D005340:Fibrinogen; D002784:Cholesterol