Occupational stress and cardiovascular disease

Abstract

This chapter reviews the evidence relating occupational stress (OS) to risk and incidence of cardiovascular disease (CVD), from the simple notion of occupational level and type as a risk marker to the more complex and theoretically more sophisticated models of occupational stress as a determinant of cardiovascular risk and disease. It does so by mapping measures of occupational stress against the three related CVD end-points of coronary risk profiles, clinical hypertension, and diagnosed events or episodes of clinical cardiovascular disease. Taken broadly, the evidence is consistently supportive of postulated links. While the evidence from studies following established theoretical models of OS appears to be both stronger and more easily interpretable, evidence from atheoretical studies employing proxy measures of OS - work hours, shift work, or perceived discrimination in the workplace, for example - has also produced evidence which is strongly supportive of the OS/CVD link. The persuasiveness of the evidence, overall, now points to the importance of OS intervention studies in the workplace undertaken according to rigorous clinical trial methodologies as the next major focus of research.