title: Job stress and major coronary events: results from the Job Stress, Absenteeism and Coronary Heart Disease in Europe study.
abstract: OBJECTIVE
  The intention of this study is to investigate the relationship of the demands/control/strain model with hard coronary events in an epidemiological, prospective, multicenter, European study.
  
  
  RESULTS
  Six cohorts (Brussels, Ghent, Lille, Barcelona, Göteborg and Malmö) from four European countries (Belgium, France, Spain and Sweden) consisting of 21 111 middle-aged male subjects participated between 1993 and 1996 in the baseline survey of the Job Stress, Absenteeism and Coronary Heart Disease in Europe (JACE) study. The Karasek strain model of psychological demands (five items)/control (nine items) was used. During a mean follow-up of 40 months 185 acute coronary events or coronary deaths were observed. Age-adjusted hazard ratios (HRs) for developing an acute coronary event were 1.46 [CI 95% confidence interval (1.08-1.97)] for high against low psychological demands and 1.53 (95% CI 1.0-2.35) for strained (high demands plus low control) against relaxed (low demands plus high control) groups. After adjustment for standard cardiovascular risk factors the HR for developing a coronary event for those above or equal to the median against those below the median of psychological demands was 1.46 (95% CI 1.08-1.97) whereas the HR for strained against relaxed groups is 1.46 (95% CI 0.96-2.25). Sensitivity analyses confirmed the robustness of the results.
  
  
  CONCLUSIONS
  In this European, multicenter, prospective, epidemiological study the Karasek job strain model was an independent predictor of acute coronary events, with the psychological demands scale emerging as the important component.
authors.affiliation: School of Public Health, Université Libre de Bruxelles, Brussels, Belgium. bmkornitzer@bezeqint.net
authors.forename: Marcel
authors.initials: M
authors.lastname: Kornitzer
authors.forename: Patrick
authors.initials: P
authors.lastname: deSmet
authors.forename: Susana
authors.initials: S
authors.lastname: Sans
authors.forename: Michele
authors.initials: M
authors.lastname: Dramaix
authors.forename: Charles
authors.initials: C
authors.lastname: Boulenguez
authors.forename: Guy
authors.initials: G
authors.lastname: DeBacker
authors.forename: Marco
authors.initials: M
authors.lastname: Ferrario
authors.forename: Irene
authors.initials: I
authors.lastname: Houtman
authors.forename: Sven-Olof
authors.initials: SO
authors.lastname: Isacsson
authors.forename: Per-Olof
authors.initials: PO
authors.lastname: Ostergren
authors.forename: Inaki
authors.initials: I
authors.lastname: Peres
authors.forename: Edwin
authors.initials: E
authors.lastname: Pelfrene
authors.forename: Monique
authors.initials: M
authors.lastname: Romon
authors.forename: Anika
authors.initials: A
authors.lastname: Rosengren
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Cesana
authors.forename: Lars
authors.initials: L
authors.lastname: Wilhelmsen
mesh_terms: D000041:Absenteeism; D000328:Adult; D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology*; D004651:Employment / Q000523:psychology*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology