APH 2002, 60, 245-268:

Job stress and cardiovascular risk factors - results from the BELSTRESS study.

E. Pelfrene, G. De Backer, R. Mak, P. de Smet and M. Kornitzer

Keywords: cardiovascular risk factors, coronary heart disease, inflammation, job strain, workrelated stress

Research over the past 50 years has time and again supplied us with an overwhelming evidence of the associations between the occurence of coronary heart disease (CHD) and risk factors such as age, male gender, smoking tabacco, arterial blood pressure, blood cholesterol, overweight and diabetes.  Over the years, attention has gradually shifted to alternative explanations in which also a less tangible factor such as job stress has gained much attention.  In this article, we focus on the relationship between job stress and conventional cardiovascular risk factors.  Cross-sectional findings from the BELSTRESS study among 16,329 men and 5,090 women working in 25 large companies all over Belgium, are presented.  Job stress was measured according to Karasek's expanded demand-control model, in which the most adverse health outcomes are expected in workers having 1) "high strain" jobs characterized by high job demands and low job control, and 2) low worksite social support.

Our findings show that the job demands are positively associated with blood pressure and with total cholesterol in men, as well as with hypertension in women after adjestment for age and level of education.  Job control shows an inverse adjusted association with the waist/hip ratio in men as well as with diabetes in both gender.  Social support only shows a positive adjusted association with regular smoking in men.  Job strain is found to be related only to regular smoking, in men and women perceiving low worksite social support.  A consistent relationship with biomarkers of inflammation is neither observed.  Limitations related to the cross-sectional nature of this study are recognized.