title: Association between job strain and risk of incident stroke: A meta-analysis.
abstract: OBJECTIVE
  Prospective cohort studies regarding job strain and the risk of stroke are controversial. This meta-analysis aimed to evaluate the association between job strain and the risk of stroke.
  
  
  METHODS
  The PubMed, Embase, and PsycINFO databases were searched for prospective cohort studies with data on job strain and the risk of stroke. Studies were included if they reported adjusted relative risks (RRs) with 95% confidence intervals (CIs) of stroke from job strain. Subgroup analyses were conducted according to sex and stroke type.
  
  
  RESULTS
  Six prospective cohort studies comprising 138,782 participants were included. High strain jobs were associated with increased risk of stroke (RR 1.22, 95% CI 1.01-1.47) compared with low strain jobs. The result was more pronounced for ischemic stroke (RR 1.58, 95% CI 1.12-2.23). The risk of stroke was significant in women (RR 1.33, 95% CI 1.04-1.69) and nonsignificant in men (RR 1.26, 95% CI 0.69-2.27), but the difference in RRs in sex subgroups was not significant. Neither active (RR 1.07, 95% CI 0.90-1.28) nor passive (RR 1.01, 95% CI 0.86-1.18) job characteristics were associated with an increased risk of stroke compared with low strain jobs.
  
  
  CONCLUSIONS
  Exposure to high strain jobs was associated with an increased risk of stroke, especially in women. Further studies are needed to confirm whether interventions to reduce work stress decrease the risk of stroke.
authors.affiliation: From the Department of Cardiology (Y. Huang, J.H., D.Z., C.L., D.X.), Nanfang Hospital, Southern Medical University, Guangzhou; Shenzhen Psychiatric College (S.X.), Anhui Medical University; Department of Psychiatry (S.X., T.L.), Shenzhen Key Laboratory of Psychological Health Center, Shenzhen; and Clinical Medicine Research Center (Y. Huang, Y. Hu), the First People's Hospital of Shunde, Foshan, PR China.
authors.forename: Yuli
authors.initials: Y
authors.lastname: Huang
authors.affiliation: From the Department of Cardiology (Y. Huang, J.H., D.Z., C.L., D.X.), Nanfang Hospital, Southern Medical University, Guangzhou; Shenzhen Psychiatric College (S.X.), Anhui Medical University; Department of Psychiatry (S.X., T.L.), Shenzhen Key Laboratory of Psychological Health Center, Shenzhen; and Clinical Medicine Research Center (Y. Huang, Y. Hu), the First People's Hospital of Shunde, Foshan, PR China.
authors.forename: Shuxian
authors.initials: S
authors.lastname: Xu
authors.affiliation: From the Department of Cardiology (Y. Huang, J.H., D.Z., C.L., D.X.), Nanfang Hospital, Southern Medical University, Guangzhou; Shenzhen Psychiatric College (S.X.), Anhui Medical University; Department of Psychiatry (S.X., T.L.), Shenzhen Key Laboratory of Psychological Health Center, Shenzhen; and Clinical Medicine Research Center (Y. Huang, Y. Hu), the First People's Hospital of Shunde, Foshan, PR China.
authors.forename: Jinghai
authors.initials: J
authors.lastname: Hua
authors.affiliation: From the Department of Cardiology (Y. Huang, J.H., D.Z., C.L., D.X.), Nanfang Hospital, Southern Medical University, Guangzhou; Shenzhen Psychiatric College (S.X.), Anhui Medical University; Department of Psychiatry (S.X., T.L.), Shenzhen Key Laboratory of Psychological Health Center, Shenzhen; and Clinical Medicine Research Center (Y. Huang, Y. Hu), the First People's Hospital of Shunde, Foshan, PR China.
authors.forename: Dingji
authors.initials: D
authors.lastname: Zhu
authors.affiliation: From the Department of Cardiology (Y. Huang, J.H., D.Z., C.L., D.X.), Nanfang Hospital, Southern Medical University, Guangzhou; Shenzhen Psychiatric College (S.X.), Anhui Medical University; Department of Psychiatry (S.X., T.L.), Shenzhen Key Laboratory of Psychological Health Center, Shenzhen; and Clinical Medicine Research Center (Y. Huang, Y. Hu), the First People's Hospital of Shunde, Foshan, PR China.
authors.forename: Changhua
authors.initials: C
authors.lastname: Liu
authors.affiliation: From the Department of Cardiology (Y. Huang, J.H., D.Z., C.L., D.X.), Nanfang Hospital, Southern Medical University, Guangzhou; Shenzhen Psychiatric College (S.X.), Anhui Medical University; Department of Psychiatry (S.X., T.L.), Shenzhen Key Laboratory of Psychological Health Center, Shenzhen; and Clinical Medicine Research Center (Y. Huang, Y. Hu), the First People's Hospital of Shunde, Foshan, PR China.
authors.forename: Yunzhao
authors.initials: Y
authors.lastname: Hu
authors.affiliation: From the Department of Cardiology (Y. Huang, J.H., D.Z., C.L., D.X.), Nanfang Hospital, Southern Medical University, Guangzhou; Shenzhen Psychiatric College (S.X.), Anhui Medical University; Department of Psychiatry (S.X., T.L.), Shenzhen Key Laboratory of Psychological Health Center, Shenzhen; and Clinical Medicine Research Center (Y. Huang, Y. Hu), the First People's Hospital of Shunde, Foshan, PR China. dinglixu@fimmu.com liutbsz@sina.com.
authors.forename: Tiebang
authors.initials: T
authors.lastname: Liu
authors.affiliation: From the Department of Cardiology (Y. Huang, J.H., D.Z., C.L., D.X.), Nanfang Hospital, Southern Medical University, Guangzhou; Shenzhen Psychiatric College (S.X.), Anhui Medical University; Department of Psychiatry (S.X., T.L.), Shenzhen Key Laboratory of Psychological Health Center, Shenzhen; and Clinical Medicine Research Center (Y. Huang, Y. Hu), the First People's Hospital of Shunde, Foshan, PR China. dinglixu@fimmu.com liutbsz@sina.com.
authors.forename: Dingli
authors.initials: D
authors.lastname: Xu
mesh_terms: D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D016526:Workload / Q000523:psychology*