The word is out on stress. Research has suggested it can be bad for your health in a number of ways, including increased risk of heart attack, stroke, and ulcers. Now Finnish researchers have found that work stress in particular may increase your risk of dying from cardiovascular diseases, such as heart disease and stroke. Their research is published in the October 19, 2002 issue of BMJ (formerly the British Medical Journal ).

About the Study

Researchers at the Universities of Helsinki and Jyväskylä, both in Finland, studied 812 factory employees in central Finland from 1973 to 2001. Jobs in these factories included metalworking, heavy engineering, precision engineering, and clerical or administrative work. Factory employees with cardiovascular disease at the start of the study were excluded.

Participants completed a work stress questionnaire that was designed to measure the following:

Job Strain – combination of high work demands with low job control

Effort-Reward Imbalance – combination of high work effort and low job reward (i.e., low salary, lack of social approval, and few career opportunities)

In addition, cholesterol, blood pressure, height and weight were measured. Participants also answered questions about physical activity, smoking, and job description.

After an average of 25 years of follow-up, researchers checked the Finnish national death registry for cause of death for study participants. They compared the number of deaths from cardiovascular disease among people with different levels and types of work stress.

The Findings

Compared with employees who had low job strain, those with high job strain were two times more likely to die of cardiovascular disease. Similarly, employees with high effort-reward imbalance were two times more likely to die of cardiovascular disease than their counterparts whose effort-reward balance was more favorable. Interestingly, employees faced with high demands or efforts, but not low control or reward, were not at increased risk of cardiovascular disease.

These numbers were adjusted for other factors that affect cardiovascular disease risk, such as age, sex, smoking, body mass index (BMI), cholesterol levels, and blood pressure.

Although these results suggest that work stress increases a person’s risk of dying from cardiovascular disease, this study has its limitations. For example, participants’ diets were not assessed (although cholesterol levels were taken into account), and some research has shown that dietary factors can affect cardiovascular disease risk independent of its affects on cholesterol. And, to make matters more interesting, stress often leads to unhealthful diets. In addition, people who take stressful factory jobs may share other common factors (for example, limited financial resources) that could increase their cardiovascular risk. Finally, participants self-reported their work stress and reward information—a method that could introduce error.

How Does This Affect You?

This study adds to existing evidence that stress may compromise your health. In particular, it provides evidence that stress at work may increase your risk of dying from cardiovascular disease.

However, this study also helps us understand why some people seem to thrive on stressful jobs and don’t suffer ill health as a result. Like many other things in life, control is the key. After all, people in this study who were faced with high work demands, but also had a great deal of control over their jobs and felt a sense of personal accomplishment, were not any more likely to die of cardiovascular disease than people with low job stress.

And remember, personal perceptions of stress vary. In other words, it is not the stressor that matters, but your response to it that counts. Some environments that are stressful to you may be a walk in the park for your coworker and visa-versa. If you feel stressed at work, regardless of what anyone else thinks about your job, you should takes steps to address it. One promising approach is to begin an exercise program, which has the potential to both alleviate stress and reduce the risk of cardiovascular disease. In addition, a stress management program may help.