• Posted September 19, 2023

Job Frustrations Can Really Be a Heartbreaker for Men

A job that's demanding but less than rewarding may take a big toll on a man's heart health, a large new study suggests.

The study, of nearly 6,500 white-collar workers, found that men who habitually felt stressed on the job had up to double the risk of developing heart disease as their peers who were more content at work.

In some cases, that stress took the form of "job strain," which meant that workers felt pressure to perform but had little power over how to get their work done.

In other cases, the central problem was "effort-reward imbalance." That's when employees feel their diligence is not winning adequate returns -- whether through pay, promotion, recognition or a sense of fulfillment.

Men who reported either kind of job stress were about 50% more likely to develop coronary heart disease over the next 18 years, versus men who were happier on the job.

Then there were the men who cited both types of job stress: Their risk of heart disease was double that of their male counterparts who reported neither work issue.

There was no similar effect, however, seen among women.

Researchers said the findings do not prove that job stress exacts a toll on men's hearts, or that it doesn't harm women.

But there are plenty of reasons that stress at work -- where adults spend so many of their waking hours -- could contribute to heart disease.

For one, chronic stress can directly affect the cardiovascular system, said Mathilde Lavigne-Robichaud, the lead researcher.

"Job strain and effort-reward imbalance can directly affect your heart by triggering physical responses that include an increase in heart rate, higher blood pressure and narrowing of blood vessels in the heart," said Lavigne-Robichaud, a doctoral candidate at CHU de Quebec-University Laval Research Center in Quebec, Canada.

"This makes the heart work harder and can lead to problems with blood flow and heart rhythm, ultimately increasing the risk of heart disease," she said.

Work stress can also harm the heart in less direct ways.

"It can interfere with your ability to eat well, exercise regularly and find time to relax," Lavigne-Robichaud said.

If it's hard to have a healthy lifestyle, she added, that would only further any direct effects of stress on the cardiovascular system.

Dr. Eduardo Sanchez agreed that chronic stress can spell trouble for the cardiovascular system -- and is possibly as harmful as obesity or secondhand smoke exposure.

Sanchez, chief medical officer for prevention at the American Heart Association, noted that the group takes workplace stress seriously. Several years ago, the AHA released guidance for employers looking to start resiliency training, as a way to address workers' stress.

The new study, Sanchez said, adds to a pile of evidence that workplaces can, and should, help promote good heart health.

The findings are based on nearly 6,500 white-collar workers in Quebec who were part of a long-term health study. At the outset, in 2000, all were free of heart disease and 45 years old, on average.

Over the next 18 years, 571 men had a first-time coronary heart disease "event" -- such as a heart attack or severe chest pain caused by blocked heart arteries. Among women, 265 suffered a similar heart complication.

Overall, the researchers found, the risk of future heart disease rose in tandem with workers' perceived job stress. That was after accounting for other factors, such as education level, marital status, smoking and drinking habits, and health conditions like diabetes and high blood pressure.

The link was only seen among men, however.

Why is unclear. And the finding should be taken with a grain of salt, both Lavigne-Robichaud and Sanchez said.

They noted that women typically develop heart disease later in life than men, and there were half as many cases among female workers in this study. That could make it harder to see a clear connection between work stress and women's heart trouble.

Lavigne-Robichaud said that the AHA and other organizations already encourage employers to have "comprehensive wellness programs" -- which may include things like health screenings and nutritious food options.

"Our study suggests that incorporating interventions aimed at reducing workplace stress into these programs could help prevent heart disease," she said.

The findings were published Sept. 19 in the journal Circulation: Cardiovascular Quality and Outcomes.

More information

The American Heart Association has advice on stress management.

SOURCES: Mathilde Lavigne-Robichaud, doctoral candidate, CHU de Quebec-University Laval Research Center, Quebec, Canada; Eduardo Sanchez, MD, MPH, chief medical officer for prevention, American Heart Association, Dallas; Circulation: Cardiovascular Quality and Outcomes, Sept. 19, 2023, online