Job, marital stress can pose heart risk
Chronic tension between spouses can raise the risk of heart disease by 25 percent, and high job stress can double the risk of a second heart attack or unstable angina, according to two studies published this week.
The reports confirm what doctors have long suspected – that chronic stress in these two areas of adult life play a key role in heart health and must be closely monitored, just like weight, blood pressure and cholesterol.
Dr. Kristina Orth-Gomer, of the Karolinska Institute in Sweden and who wrote an editorial accompanying one of the studies, said doctors have to recognize stress as a significant risk factor and talk with their patients about it. Although the topic might seem awkward, she said, “in my experience … patients are very relieved to start talking, and the conversation may be just the therapy” they need.
The job-stress study, published today in the Journal of the American Medical Association, looked at 866 men and 106 women from 30 hospitals around Quebec who returned to work for at least 10 hours a week within 18 months of a first heart attack. Researchers, led by Dr. Corine Aboa-Eboule of Laval University in Montreal, tracked the participants, whose ages ranged from 35 to 59, for six years.
Participants answered questions about job stress at three times during the study: when it began, after two years and at six years. Job stress was determined by a number of factors, including quantity of work, intellectual requirements, time constraints and the latitude to make decisions, be creative and develop or acquire skills.
Researchers found that jobs with high demands and little autonomy carried the most stress, and the people in those jobs tended to be female, less educated, less physically active and more likely to smoke than people in low-stress jobs.
The study found no increased risk associated with job stress during the first two years of the study. Co-author Dr. Alain Milot of Laval University said researchers surmised it takes more than two years for the effects of chronic stress to develop, a factor that might help explain why some short-term studies have found no association between heart disease and job stress.
The second report, published Monday in the Archives of Internal Medicine, tracked 6,114 male and 2,897 female British civil servants for a period of 12 years.
Lead author Roberto DeVogli, an epidemiologist with University College in London, said the added risk associated with marital stress was small compared with the effects of such established risk factors as obesity, high blood pressure, diabetes and high cholesterol.
Nonetheless, he said, it was important for patients to know that marital stress might increase their chances of developing heart disease.
At the start of the study, participants completed questionnaires about their intimate relationships and overall health.
Researchers found that an inability to confide in a spouse or a lack of support from a partner had no affect on heart disease risk.
But participants who said their spouses increased their anxiety and generally made things worse were at greater risk, even when a long list of established risk factors, including hypertension, smoking and lack of exercise, and psychological conditions such as depression, were taken into account.
Stressful marriages affected men and women equally.