title: A cross-sectional study of the relationship between job demand-control, effort-reward imbalance and cardiovascular heart disease risk factors.
abstract: BACKGROUND
  This cross-sectional study explored relationships between psychosocial work environment, captured by job demand-control (JDC) and effort-reward imbalance (ERI), and seven cardiovascular heart disease (CHD) risk factors in a general population.
  
  
  METHODS
  The sampled consists of randomly-selected men and women from Gothenburg, Sweden and the city's surrounding metropolitan areas. Associations between psychosocial variables and biomarkers were analysed with multiple linear regression adjusted for age, smoking, education and occupational status.
  
  
  RESULTS
  The study included 638 men and 668 women aged 24-71. Analysis between JDC and CHD risk factors illustrated that, for men, JDC was associated with impaired scores in several biomarkers, especially among those in high strain jobs. For women, there were no relationships between JDC and biomarkers. In the analysis of links between ERI and CHD risk factors, most associations tested null. The only findings were raised triglycerides and BMI among men in the fourth quartile of the ERI-ratio distribution, and lowered LDL-cholesterol for women. An complementary ERI analysis, combining high/low effort and reward into categories, illustrated lowered triglycerides and elevated HDL-cholesterol values among women reporting high efforts and high rewards, compared to women experiencing low effort and high reward.
  
  
  CONCLUSIONS
  There were some associations between psychosocial stressors and CHD risk factors. The cross-sectional design did not allow conclusions about causality but some results indicated gender differences regarding sensitivity to work stressors and also how the models might capture different psychosocial dimensions.
authors.affiliation: Department of Occupational and Environmental Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 414405 30, Gothenburg, Sweden. mia.soderberg@amm.gu.se
authors.forename: Mia
authors.initials: M
authors.lastname: Söderberg
authors.forename: Annika
authors.initials: A
authors.lastname: Rosengren
authors.forename: Jenny
authors.initials: J
authors.lastname: Hillström
authors.forename: Lauren
authors.initials: L
authors.lastname: Lissner
authors.forename: Kjell
authors.initials: K
authors.lastname: Torén
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002784:Cholesterol / Q000097:blood; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012201:Reward; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood; D014505:Urban Population; D016526:Workload / Q000523:psychology*; D055815:Young Adult
chemical_list: D014280:Triglycerides; D002784:Cholesterol