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Effort-reward imbalance at work and recurrent coronary heart disease events: a 4-year prospective study of post-myocardial infarction patients.

Abstract

OBJECTIVE

Prospective studies have shown that effort-reward imbalance (ERI) at work is associated with the incidence of a first coronary heart disease (CHD) event. However, it is unknown whether ERI at work increases the risk of recurrent CHD events. The objective of this study was to determine whether ERI at work and its components (effort and reward) increase the risk of recurrent CHD in post-myocardial infarction (post-MI) workers.

METHODS

We carried out a prospective cohort study of 669 men and 69 women who returned to work after a first MI. ERI at work was assessed by telephone interview using validated scales of reward and psychological demands. The outcome was a composite of fatal CHD, nonfatal MI, and unstable angina. CHD risk factors were documented in medical files and by interview. The participants were followed up for a mean period of 4.0 years (1998-2005).

RESULTS

During the follow-up, 96 CHD events were documented. High ERI and low reward were associated with recurrent CHD (respective adjusted hazard ratios [HRs] = 1.75, 95% confidence interval [CI] = 0.99-3.08, and HR = 1.77, 95% CI = 1.16-2.71). There was a gender interaction showing stronger effects among women (respective adjusted HRs for high ERI and low reward: HR = 3.95, 95% CI = 0.93-16.79, and HR = 9.53, 95% CI = 1.15-78.68).

CONCLUSIONS

Post-MI workers holding jobs that involved ERI or low reward had increased risk of recurrent CHD.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Centre de recherche du CHA, Unité de recherche en santé des populations, Québec City, Canada.

    , , , , ,

    Source

    Psychosomatic medicine 73:6 pg 436-47

    MeSH

    Angina, Unstable
    Confounding Factors (Epidemiology)
    Coronary Disease
    Employment
    Female
    Health Status
    Hospitalization
    Humans
    Job Satisfaction
    Life Style
    Male
    Middle Aged
    Models, Theoretical
    Myocardial Infarction
    Proportional Hazards Models
    Prospective Studies
    Recurrence
    Reward
    Risk Factors
    Sex Factors
    Stress, Psychological
    Workload

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    21705691

    Citation

    Aboa-Éboulé, Corine, et al. "Effort-reward Imbalance at Work and Recurrent Coronary Heart Disease Events: a 4-year Prospective Study of Post-myocardial Infarction Patients." Psychosomatic Medicine, vol. 73, no. 6, 2011, pp. 436-47.
    Aboa-Éboulé C, Brisson C, Maunsell E, et al. Effort-reward imbalance at work and recurrent coronary heart disease events: a 4-year prospective study of post-myocardial infarction patients. Psychosom Med. 2011;73(6):436-47.
    Aboa-Éboulé, C., Brisson, C., Maunsell, E., Bourbonnais, R., Vézina, M., Milot, A., & Dagenais, G. R. (2011). Effort-reward imbalance at work and recurrent coronary heart disease events: a 4-year prospective study of post-myocardial infarction patients. Psychosomatic Medicine, 73(6), pp. 436-47. doi:10.1097/PSY.0b013e318222b2d8.
    Aboa-Éboulé C, et al. Effort-reward Imbalance at Work and Recurrent Coronary Heart Disease Events: a 4-year Prospective Study of Post-myocardial Infarction Patients. Psychosom Med. 2011;73(6):436-47. PubMed PMID: 21705691.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effort-reward imbalance at work and recurrent coronary heart disease events: a 4-year prospective study of post-myocardial infarction patients. AU - Aboa-Éboulé,Corine, AU - Brisson,Chantal, AU - Maunsell,Elizabeth, AU - Bourbonnais,Renée, AU - Vézina,Michel, AU - Milot,Alain, AU - Dagenais,Gilles R, Y1 - 2011/06/24/ PY - 2011/6/28/entrez PY - 2011/6/28/pubmed PY - 2012/3/16/medline SP - 436 EP - 47 JF - Psychosomatic medicine JO - Psychosom Med VL - 73 IS - 6 N2 - OBJECTIVE: Prospective studies have shown that effort-reward imbalance (ERI) at work is associated with the incidence of a first coronary heart disease (CHD) event. However, it is unknown whether ERI at work increases the risk of recurrent CHD events. The objective of this study was to determine whether ERI at work and its components (effort and reward) increase the risk of recurrent CHD in post-myocardial infarction (post-MI) workers. METHODS: We carried out a prospective cohort study of 669 men and 69 women who returned to work after a first MI. ERI at work was assessed by telephone interview using validated scales of reward and psychological demands. The outcome was a composite of fatal CHD, nonfatal MI, and unstable angina. CHD risk factors were documented in medical files and by interview. The participants were followed up for a mean period of 4.0 years (1998-2005). RESULTS: During the follow-up, 96 CHD events were documented. High ERI and low reward were associated with recurrent CHD (respective adjusted hazard ratios [HRs] = 1.75, 95% confidence interval [CI] = 0.99-3.08, and HR = 1.77, 95% CI = 1.16-2.71). There was a gender interaction showing stronger effects among women (respective adjusted HRs for high ERI and low reward: HR = 3.95, 95% CI = 0.93-16.79, and HR = 9.53, 95% CI = 1.15-78.68). CONCLUSIONS: Post-MI workers holding jobs that involved ERI or low reward had increased risk of recurrent CHD. SN - 1534-7796 UR - https://www.unboundmedicine.com/medline/citation/21705691/Effort_reward_imbalance_at_work_and_recurrent_coronary_heart_disease_events:_a_4_year_prospective_study_of_post_myocardial_infarction_patients_ L2 - http://Insights.ovid.com/pubmed?pmid=21705691 DB - PRIME DP - Unbound Medicine ER -