title: Job strain and cardiovascular disease risk factors: meta-analysis of individual-participant data from 47,000 men and women.
abstract: BACKGROUND
  Job strain is associated with an increased coronary heart disease risk, but few large-scale studies have examined the relationship of this psychosocial characteristic with the biological risk factors that potentially mediate the job strain - heart disease association.
  
  
  RESULTS
  We pooled cross-sectional, individual-level data from eight studies comprising 47,045 participants to investigate the association between job strain and the following cardiovascular disease risk factors: diabetes, blood pressure, pulse pressure, lipid fractions, smoking, alcohol consumption, physical inactivity, obesity, and overall cardiovascular disease risk as indexed by the Framingham Risk Score. In age-, sex-, and socioeconomic status-adjusted analyses, compared to those without job strain, people with job strain were more likely to have diabetes (odds ratio 1.29; 95% CI: 1.11-1.51), to smoke (1.14; 1.08-1.20), to be physically inactive (1.34; 1.26-1.41), and to be obese (1.12; 1.04-1.20). The association between job strain and elevated Framingham risk score (1.13; 1.03-1.25) was attributable to the higher prevalence of diabetes, smoking and physical inactivity among those reporting job strain.
  
  
  CONCLUSIONS
  In this meta-analysis of work-related stress and cardiovascular disease risk factors, job strain was linked to adverse lifestyle and diabetes. No association was observed between job strain, clinic blood pressure or blood lipids.
authors.affiliation: Finnish Institute of Occupational Health, Helsinki and Tampere, Finland. solja.nyberg@ttl.fi
authors.forename: Solja T
authors.initials: ST
authors.lastname: Nyberg
authors.forename: Eleonor I
authors.initials: EI
authors.lastname: Fransson
authors.forename: Katriina
authors.initials: K
authors.lastname: Heikkilä
authors.forename: Lars
authors.initials: L
authors.lastname: Alfredsson
authors.forename: Annalisa
authors.initials: A
authors.lastname: Casini
authors.forename: Els
authors.initials: E
authors.lastname: Clays
authors.forename: Dirk
authors.initials: D
authors.lastname: De Bacquer
authors.forename: Nico
authors.initials: N
authors.lastname: Dragano
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.forename: Jane E
authors.initials: JE
authors.lastname: Ferrie
authors.forename: Mark
authors.initials: M
authors.lastname: Hamer
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Jöckel
authors.forename: France
authors.initials: F
authors.lastname: Kittel
authors.forename: Anders
authors.initials: A
authors.lastname: Knutsson
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Ladwig
authors.forename: Thorsten
authors.initials: T
authors.lastname: Lunau
authors.forename: Michael G
authors.initials: MG
authors.lastname: Marmot
authors.forename: Maria
authors.initials: M
authors.lastname: Nordin
authors.forename: Reiner
authors.initials: R
authors.lastname: Rugulies
authors.forename: Johannes
authors.initials: J
authors.lastname: Siegrist
authors.forename: Andrew
authors.initials: A
authors.lastname: Steptoe
authors.forename: Peter J M
authors.initials: PJ
authors.lastname: Westerholm
authors.forename: Hugo
authors.initials: H
authors.lastname: Westerlund
authors.forename: Töres
authors.initials: T
authors.lastname: Theorell
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Brunner
authors.forename: Archana
authors.initials: A
authors.lastname: Singh-Manoux
authors.forename: G David
authors.initials: GD
authors.lastname: Batty
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*; D014937:Work / Q000523:psychology*