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Job strain and risk of acute recurrent coronary heart disease events.
JAMA 2007; 298(14):1652-60JAMA

Abstract

CONTEXT

There is evidence that job strain increases the risk of a first coronary heart disease (CHD) event. However, little is known about its association with the risk of recurrent CHD events after a first myocardial infarction (MI).

OBJECTIVE

To determine whether job strain increases the risk of recurrent CHD events.

DESIGN, SETTING, AND PATIENTS

Prospective cohort study of 972 men and women aged 35 to 59 years who returned to work after a first MI and were then followed up between February 10, 1996, and June 22, 2005. Patients were interviewed at baseline (on average, 6 weeks after their return to work), then after 2 and 6 years subsequently. Job strain, a combination of high psychological demands and low decision latitude, was evaluated in 4 quadrants: high strain (high demands and low latitude), active (high demands and high latitude), passive (low demands and low latitude), and low strain. A chronic job strain variable was constructed based on the first 2 interviews, and patients were divided into those exposed to high strain at both interviews and those unexposed to high strain at 1 or both interviews. The survival analyses were presented separately for 2 periods: before 2.2 years and at 2.2 years and beyond.

MAIN OUTCOME MEASURE

The outcome was a composite of fatal CHD, nonfatal MI, and unstable angina.

RESULTS

The outcome was documented in 206 patients. In the unadjusted analysis, chronic job strain was associated with recurrent CHD in the second period after 2.2 years of follow-up (hazard ratio [HR], 2.20; 95% CI, 1.32-3.66; respective event rates for patients exposed and unexposed to chronic job strain, 6.18 and 2.81 per 100 person-years). Chronic job strain remained an independent predictor of recurrent CHD in a multivariate model adjusted for 26 potentially confounding factors (HR, 2.00; 95% CI, 1.08-3.72).

CONCLUSION

Chronic job strain after a first MI was associated with an increased risk of recurrent CHD.

Authors+Show Affiliations

Unité de Recherché en Santé des Populations, Université Laval, Québec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17925517

Citation

Aboa-Eboulé, Corine, et al. "Job Strain and Risk of Acute Recurrent Coronary Heart Disease Events." JAMA, vol. 298, no. 14, 2007, pp. 1652-60.
Aboa-Eboulé C, Brisson C, Maunsell E, et al. Job strain and risk of acute recurrent coronary heart disease events. JAMA. 2007;298(14):1652-60.
Aboa-Eboulé, C., Brisson, C., Maunsell, E., Mâsse, B., Bourbonnais, R., Vézina, M., ... Dagenais, G. R. (2007). Job strain and risk of acute recurrent coronary heart disease events. JAMA, 298(14), pp. 1652-60.
Aboa-Eboulé C, et al. Job Strain and Risk of Acute Recurrent Coronary Heart Disease Events. JAMA. 2007 Oct 10;298(14):1652-60. PubMed PMID: 17925517.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Job strain and risk of acute recurrent coronary heart disease events. AU - Aboa-Eboulé,Corine, AU - Brisson,Chantal, AU - Maunsell,Elizabeth, AU - Mâsse,Benoît, AU - Bourbonnais,Renée, AU - Vézina,Michel, AU - Milot,Alain, AU - Théroux,Pierre, AU - Dagenais,Gilles R, PY - 2007/10/11/pubmed PY - 2007/10/18/medline PY - 2007/10/11/entrez SP - 1652 EP - 60 JF - JAMA JO - JAMA VL - 298 IS - 14 N2 - CONTEXT: There is evidence that job strain increases the risk of a first coronary heart disease (CHD) event. However, little is known about its association with the risk of recurrent CHD events after a first myocardial infarction (MI). OBJECTIVE: To determine whether job strain increases the risk of recurrent CHD events. DESIGN, SETTING, AND PATIENTS: Prospective cohort study of 972 men and women aged 35 to 59 years who returned to work after a first MI and were then followed up between February 10, 1996, and June 22, 2005. Patients were interviewed at baseline (on average, 6 weeks after their return to work), then after 2 and 6 years subsequently. Job strain, a combination of high psychological demands and low decision latitude, was evaluated in 4 quadrants: high strain (high demands and low latitude), active (high demands and high latitude), passive (low demands and low latitude), and low strain. A chronic job strain variable was constructed based on the first 2 interviews, and patients were divided into those exposed to high strain at both interviews and those unexposed to high strain at 1 or both interviews. The survival analyses were presented separately for 2 periods: before 2.2 years and at 2.2 years and beyond. MAIN OUTCOME MEASURE: The outcome was a composite of fatal CHD, nonfatal MI, and unstable angina. RESULTS: The outcome was documented in 206 patients. In the unadjusted analysis, chronic job strain was associated with recurrent CHD in the second period after 2.2 years of follow-up (hazard ratio [HR], 2.20; 95% CI, 1.32-3.66; respective event rates for patients exposed and unexposed to chronic job strain, 6.18 and 2.81 per 100 person-years). Chronic job strain remained an independent predictor of recurrent CHD in a multivariate model adjusted for 26 potentially confounding factors (HR, 2.00; 95% CI, 1.08-3.72). CONCLUSION: Chronic job strain after a first MI was associated with an increased risk of recurrent CHD. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/17925517/Job_strain_and_risk_of_acute_recurrent_coronary_heart_disease_events_ L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.298.14.1652 DB - PRIME DP - Unbound Medicine ER -