title: The association between job strain and coronary heart disease: a meta-analysis of prospective cohort studies.
abstract: BACKGROUND
  Studies about work stress and the risk of coronary heart disease (CHD) have yielded inconsistent results. This meta-analysis aimed to investigate the association between job strain and the risk of CHD.
  
  
  METHODS
  We searched PubMed and Embase databases for studies reporting data on job strain and the risk of CHD. Studies were included if they reported multiple-adjusted relative risk (RR) with 95% confidence interval (CI) with respect to CHD from job strain.
  
  
  RESULTS
  Fourteen prospective cohort studies comprising 232,767 participants were included. The risk of CHD was increased in high-strain (RR 1.26; 95% CI 1.12-1.41) and passive jobs (RR 1.14; 95% CI 1.02-1.29) but not in active jobs (RR 1.09; 95% CI 0.97-1.22), when compared with low-strain group. The increased risk of CHD in high-strain and passive jobs was mainly driven by studies with a follow-up duration of ≥ 10 years. Neither the low-control (RR 1.06; 95% CI 0.93-1.19) nor high-demand (RR 1.13; 95% CI 0.97-1.32) dimension was independently associated with the risk of CHD.
  
  
  CONCLUSIONS
  Individuals with high-strain and passive jobs were more likely to experience a CHD event. Intervention programs incorporating individual and organizational levels are crucial for reducing job strain and the risk of CHD.
authors.affiliation: a Shenzhen Psychiatric College, Anhui Medical University , Shenzhen, Guangdong , PR China.|b Department of Psychiatry , Shenzhen Key Laboratory of Psychological Health Center , Shenzhen, Guangdong , PR China.
authors.forename: Shuxian
authors.initials: S
authors.lastname: Xu
authors.affiliation: c Department of Cardiology , the First People's Hospital of Shunde (the Affiliated Hospital at Shunde, Southern Medical University) , Foshan, Guangdong , China.
authors.forename: Yuli
authors.initials: Y
authors.lastname: Huang
authors.affiliation: d Department of Medical Psychology , Anhui Medical University , Hefei, Anhui , PR China.
authors.forename: Jiping
authors.initials: J
authors.lastname: Xiao
authors.affiliation: d Department of Medical Psychology , Anhui Medical University , Hefei, Anhui , PR China.
authors.forename: Wenjing
authors.initials: W
authors.lastname: Zhu
authors.affiliation: e School of Nursing, Anhui Medical University , Hefei, Anhui , PR China.
authors.forename: Lulu
authors.initials: L
authors.lastname: Wang
authors.affiliation: c Department of Cardiology , the First People's Hospital of Shunde (the Affiliated Hospital at Shunde, Southern Medical University) , Foshan, Guangdong , China.
authors.forename: Hongfeng
authors.initials: H
authors.lastname: Tang
authors.affiliation: c Department of Cardiology , the First People's Hospital of Shunde (the Affiliated Hospital at Shunde, Southern Medical University) , Foshan, Guangdong , China.
authors.forename: Yunzhao
authors.initials: Y
authors.lastname: Hu
authors.affiliation: b Department of Psychiatry , Shenzhen Key Laboratory of Psychological Health Center , Shenzhen, Guangdong , PR China.
authors.forename: Tiebang
authors.initials: T
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology*; D004651:Employment / Q000523:psychology; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D016526:Workload / Q000523:psychology*; D055815:Young Adult
keywords: Coronary heart disease; job strain; meta-analysis; work stress