Work stress and risk of death in men and women with and without cardiometabolic disease: a multicohort study

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Work stress and risk of death in men and women with and without cardiometabolic disease : a multicohort study

Kivimäki, Mika (författare): Clinicum, Faculty of Medicine, and Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland / Department of Epidemiology and Public Health, University College London, London, United Kingdom,UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England;Univ Helsinki, Clinicum, Fac Med, Helsinki, Finland;Univ Helsinki, Helsinki Inst Life Sci, Helsinki, Finland

Pentti, Jaana (författare): Clinicum, Faculty of Medicine, and Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland / Department of Public Health, University of Turku, Turku, Finland,Univ Helsinki, Clinicum, Fac Med, Helsinki, Finland;Univ Helsinki, Helsinki Inst Life Sci, Helsinki, Finland;Univ Turku, Dept Publ Hlth, Turku, Finland

Ferrie, Jane E. (författare): Department of Epidemiology and Public Health, University College London, London, United Kingdom / School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom,Univ Bristol, Sch Social & Community Med, Bristol, Avon, England;UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England

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Batty, G David. (författare): Department of Epidemiology and Public Health, University College London, London, United Kingdom,UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.

Theorell, Töres (författare): Karolinska Institutet,Stockholms universitet,Stressforskningsinstitutet,Univ Helsinki, Clinicum, Fac Med, Helsinki, Finland;Univ Helsinki, Helsinki Inst Life Sci, Helsinki, Finland,Stockholm Univ, Stress Res Inst, Stockholm, Sweden;Finnish Inst Occupat Hlth, Helsinki, Finland

Jokela, Markus (författare): Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland,Univ Helsinki, Inst Behav Sci, Helsinki, Finland,Uppsala Univ, Uppsala,Department of Medical Sciences, Uppsala University, Uppsala, Sweden

Virtanen, Marianna (författare): Uppsala universitet,Folkhälsovetenskap

Alfredsson, Lars (författare): Karolinska Institutet

Dragano, Nico (författare): Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany,Univ Dusseldorf, Med Fac, Inst Med Sociol, Dusseldorf, Germany

Fransson, Eleonor I., 1971- (författare): Stockholms universitet,Jönköping University,HHJ, Avdelningen för naturvetenskap och biomedicin,HHJ. ADULT,Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden / School of Health and Welfare, Jönköping University, Jönköping, Sweden / Stress Research Institute, Stockholm University, Stockholm, Sweden,Stressforskningsinstitutet,Stockholm Cty Council, Ctr Occupat & Environm Med, Stockholm, Sweden;Jonkoping Univ, Sch Hlth & Welf, Jonkoping, Sweden;Stockholm Univ, Stress Res Inst, Stockholm, Sweden

Goldberg, Marcel (författare): Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France / Versailles St-Quentin University, UMS 011, Villejuif, France,INSERM, Populat Based Epidemiol Cohorts Unit, UMS 011, Villejuif, France;Versailles St Quentin Univ, UMS 011, Villejuif, France

Knutsson, Anders, 1942- (författare): Mittuniversitetet,Avdelningen för hälsovetenskap,Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden,Mid Sweden Univ, Dept Hlth Sci, Sundsvall, Sweden

Koskenvuo, Markku (författare): Department of Public Health, University of Helsinki, Helsinki, Finland,Univ Helsinki, Dept Publ Hlth, Helsinki, Finland

Koskinen, Aki (författare): Finnish Institute of Occupational Health, Helsinki, Finland,Finnish Inst Occupat Hlth, Helsinki, Finland

Kouvonen, Anne (författare): Faculty of Social Sciences, University of Helsinki, Helsinki, Finland / Division of Health Psychology, SWPS University of Social Sciences and Humanities in Wroclaw, Wroclaw, Poland / Administrative Data Research Centre Northern Ireland, Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom,Univ Helsinki, Fac Social Sci, Helsinki, Finland;Queens Univ Belfast, Ctr Publ Hlth, Adm Data Res Ctr Northern Ireland, Belfast, Antrim, North Ireland;SWPS Univ Social Sci & Humanities Wroclaw, Div Hlth Psychol, Wroclaw, Poland

Luukkonen, Ritva (författare): Clinicum, Faculty of Medicine, and Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland,Univ Helsinki, Clinicum, Fac Med, Helsinki, Finland;Univ Helsinki, Helsinki Inst Life Sci, Helsinki, Finland

Oksanen, Tuula (författare): Finnish Institute of Occupational Health, Helsinki, Finland

Rugulies, Reiner (författare): National Research Centre for the Working Environment, Copenhagen, Denmark / Department of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark,Natl Res Ctr Working Environm, Copenhagen, Denmark;Univ Copenhagen, Dept Publ Hlth, Copenhagen, Denmark;Univ Copenhagen, Dept Psychol, Copenhagen, Denmark

Siegrist, Johannes (författare): Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany,Univ Dusseldorf, Med Fac, Inst Med Sociol, Dusseldorf, Germany

Singh-Manoux, Archana (författare): Department of Epidemiology and Public Health, University College London, London, United Kingdom / Inserm UMR 1018, Centre for Research in Epidemiology and Population Health, Villejuif, France,UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England;Ctr Res Epidemiol & Populat Hlth, INSERM, UMR 1018, Villejuif, France

Suominen, Sakari (författare): Högskolan i Skövde,Institutionen för hälsa och lärande,Forskningsspecialiseringen Hälsa och Lärande,Department of Public Health, University of Turku, Turku, Finland / Folkhälsan Research Center, Helsinki, Finland / School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, United Kingdom,Individ och samhälle, Individual and Society (VIDSOC),Folkhalsan Res Ctr, Helsinki, Finland;Univ Skovde, Sch Hlth & Educ, Skovde, Sweden;Univ Kent, Sch Social Policy Sociol & Social Res, Canterbury, Kent, England;Univ Turku, Dept Publ Hlth, Turku, Finland

Theorell, Töres (författare): Stress Research Institute, Stockholm University, Stockholm, Sweden

Väänänen, Ari (författare): Finnish Institute of Occupational Health, Helsinki, Finland,Finnish Inst Occupat Hlth, Helsinki, Finland

Vahtera, Jussi (författare): Department of Public Health, University of Turku, Turku, Finland / Turku University Hospital, Turku, Finland,Turku Univ Hosp, Turku, Finland;Univ Turku, Dept Publ Hlth, Turku, Finland

Westerholm, Peter (författare): Uppsala universitet,Arbets- och miljömedicin

Westerlund, Hugo (författare): Stockholms universitet,Stressforskningsinstitutet,Stockholm Univ, Stress Res Inst, Stockholm, Sweden

Zins, Marie (författare): Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France / Versailles St-Quentin University, UMS 011, Villejuif, France,INSERM, Populat Based Epidemiol Cohorts Unit, UMS 011, Villejuif, France;Versailles St Quentin Univ, UMS 011, Villejuif, France

Strandberg, Timo (författare): Clinicum, Faculty of Medicine, and Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland / Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland / Center for Life Course Health Research, University of Oulu, Oulu, Finland,Helsinki Univ Hosp, Dept Internal Med, Helsinki, Finland;Univ Helsinki, Clinicum, Fac Med, Helsinki, Finland;Univ Helsinki, Helsinki Inst Life Sci, Helsinki, Finland;Univ Oulu, Ctr Life Course Hlth Res, Oulu, Finland

Steptoe, Andrew (författare): Department of Epidemiology and Public Health, University College London, London, United Kingdom,UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England

Deanfield, John (författare): National Centre for Cardiovascular Prevention and Outcomes, University College London, London, United Kingdom,UCL, Natl Ctr Cardiovasc Prevent & Outcomes, London, England

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Elsevier, 2018
2018
Engelska.
Ingår i: The Lancet Diabetes and Endocrinology. - : Elsevier. - 2213-8587 .- 2213-8595. ; 6:9, s. 705-713

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

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BACKGROUND: Although some cardiovascular disease prevention guidelines suggest a need to manage work stress in patients with established cardiometabolic disease, the evidence base for this recommendation is weak. We sought to clarify the status of stress as a risk factor in cardiometabolic disease by investigating the associations between work stress and mortality in men and women with and without pre-existing cardiometabolic disease.METHODS: In this multicohort study, we used data from seven cohort studies in the IPD-Work consortium, initiated between 1985 and 2002 in Finland, France, Sweden, and the UK, to examine the association between work stress and mortality. Work stress was denoted as job strain or effort-reward imbalance at work. We extracted individual-level data on prevalent cardiometabolic diseases (coronary heart disease, stroke, or diabetes [without differentiation by diabetes type]) at baseline. Work stressors, socioeconomic status, and conventional and lifestyle risk factors (systolic and diastolic blood pressure, total cholesterol, smoking status, BMI, physical activity, and alcohol consumption) were also assessed at baseline. Mortality data, including date and cause of death, were obtained from national death registries. We used Cox proportional hazards regression to study the associations of work stressors with mortality in men and women with and without cardiometabolic disease.RESULTS: We identified 102 633 individuals with 1 423 753 person-years at risk (mean follow-up 13·9 years [SD 3·9]), of whom 3441 had prevalent cardiometabolic disease at baseline and 3841 died during follow-up. In men with cardiometabolic disease, age-standardised mortality rates were substantially higher in people with job strain (149·8 per 10 000 person-years) than in those without (97·7 per 10 000 person-years; mortality difference 52·1 per 10 000 person-years; multivariable-adjusted hazard ratio [HR] 1·68, 95% CI 1·19-2·35). This mortality difference for job strain was almost as great as that for current smoking versus former smoking (78·1 per 10 000 person-years) and greater than those due to hypertension, high total cholesterol concentration, obesity, physical inactivity, and high alcohol consumption relative to the corresponding lower risk groups (mortality difference 5·9-44·0 per 10 000 person-years). Excess mortality associated with job strain was also noted in men with cardiometabolic disease who had achieved treatment targets, including groups with a healthy lifestyle (HR 2·01, 95% CI 1·18-3·43) and those with normal blood pressure and no dyslipidaemia (6·17, 1·74-21·9). In all women and in men without cardiometabolic disease, relative risk estimates for the work stress-mortality association were not significant, apart from effort-reward imbalance in men without cardiometabolic disease (mortality difference 6·6 per 10 000 person-years; multivariable-adjusted HR 1·22, 1·06-1·41).INTERPRETATION: In men with cardiometabolic disease, the contribution of job strain to risk of death was clinically significant and independent of conventional risk factors and their treatment, and measured lifestyle factors. Standard care targeting conventional risk factors is therefore unlikely to mitigate the mortality risk associated with job strain in this population.FUNDING: NordForsk, UK Medical Research Council, and Academy of Finland.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Occupational Health and Environmental Health (hsv//eng)

Nyckelord

Individual and Society VIDSOC
Individ och samhälle VIDSOC

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