title: Involuntary job loss as a risk factor for subsequent myocardial infarction and stroke: findings from the Health and Retirement Survey.
abstract: BACKGROUND
  The role of stress in the development of cardiovascular disease is well established. Previous research has demonstrated that involuntary job loss in the years immediately preceding retirement can be a stressful life event shown to produce adverse changes in physical and affective health. The objective of this study was to estimate the risk of myocardial infarction (MI) and stroke associated with involuntary job loss among workers nearing retirement in the United States.
  
  
  METHODS
  We used multivariable survival analysis to analyze data from the first four waves of the Health and Retirement Survey (HRS), a nationally representative sample of older individuals in the US. The analytic sample includes 457 workers who experienced job loss and a comparison group of 3,763 employed individuals.
  
  
  RESULTS
  The results indicate that involuntary job loss is not associated with subsequent risk of MI (adjusted HR = 1.89; 95% CI = 0.91, 3.93); the risk of subsequent stroke associated with involuntary job loss is more than double (adjusted HR = 2.64; 95% CI = 1.01, 6.94).
  
  
  CONCLUSIONS
  Our findings present new data to suggest that involuntary job loss should be considered as a plausible risk factor for subsequent cardiovascular and cerebrovascular illness among older workers.
authors.affiliation: Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut 06510, USA. william.gallo@yale.edu
authors.forename: William T
authors.initials: WT
authors.lastname: Gallo
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Bradley
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Falba
authors.forename: Joel A
authors.initials: JA
authors.lastname: Dubin
authors.forename: Laura D
authors.initials: LD
authors.lastname: Cramer
authors.forename: Sidney T
authors.initials: ST
authors.lastname: Bogardus
authors.forename: Stanislav V
authors.initials: SV
authors.lastname: Kasl
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000523:psychology*; D011446:Prospective Studies; D012179:Retirement / Q000523:psychology; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology; D020521:Stroke / Q000209:etiology / Q000523:psychology*; D014478:Unemployment / Q000523:psychology*; D014481:United States