News Review From Harvard Medical School -- Powerless, Stressful Jobs Boost Heart Attacks
Having a high-stress job with little control over your work may increase your risk of a heart attack, a new study finds. The study assessed job stress for nearly 200,000 workers with no history of heart disease. People filled our surveys about their job demands, workload, time pressures and their freedom to make decisions. Then researchers kept track of them for an average of 7½ years. In that time, nearly 2,400 people had their first non-fatal heart attack. Heart attacks were 23% more common among people who had demanding jobs but little role in decision making. Researchers cautioned that the cause might not be the work stress itself. People could cope with stress partly by doing things that are bad for their health, such as smoking more. In any case, the effect of job stress was less than other risks, such as lack of exercise. The journal Lancet published the study. HealthDay News wrote about it September 14.
By Howard LeWine, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
About 22% of Americans have a lot of stress all the time. That's the finding of a survey released early this year by the American Psychological Association. For many, what happens at work contributes a great deal to stress level.
A common perception of a stressful job is one that requires juggling multiple tasks, managing many people and/or being responsible for care or safety of others. But the most stressful jobs don't fit this profile. Instead, they are jobs that require meeting deadlines with little or no control over how the job is done. People who have more influence on decision making score lower on stress scales, even if the demands of the job are intense.
These conclusions are confirmed again in this new study, which looks at the link between stress and heart disease. The researchers acknowledge that the increased stress from certain types of jobs might not be the direct cause. It could be that the increased stress caused people to smoke more, exercise less and eat less healthy foods.
But if stress is a cause, how might it promote heart disease or make it worse? No one really knows.
A leading theory blames a lasting high level of stress hormones, such as adrenalin. This hormone narrows blood vessels and speeds up the heartbeat. Adrenalin and other stress hormones make the heart and blood vessels especially likely to react to further stress. Stress hormones have also been linked to increases in inflammation. And inflammation plays an important role in atherosclerosis, the clogging of arteries.
All of these factors could contribute to the greater heart attack risk noted in this study.
What Changes Can I Make Now?
A little temporary stress is neither bad nor good. A little dose of stress, for example, can motivate you to face a challenge or finish a project. Constant stress, though, can be harmful.
It may not be easy, but the first step is admitting to yourself that you're feeling constantly stressed. Of course, you want to talk with your supervisor. But there are some things you can do personally to reduce your response to stress.
Instead of stress leading to a surge in stress hormones, you can counter this with what is called the relaxation response. Here are some ways to get there:
- Deep but unforced breathing
- Focusing on a soothing word, such as peace or calm
- Visualizing a tranquil scene, such as a place you have been where you feel calm and relaxed
- Tai chi
All of these take practice and patience.
It's also essential to be aware of how the stress may cause you to pay less attention to your health. It may be harder than usual, but you still need to:
- Not smoke
- Eat a healthy diet loaded with fruits, vegetables and whole grain foods
- Stay physically active and dedicate some time every day for exercise
- Take the blood pressure and cholesterol medicines your doctor prescribes
What Can I Expect Looking to the Future?
The link between lasting stress and heart disease is only one negative health effect. Stress also is linked with a less effective immune system. And clearly when one is stressed, concentration and memory become impaired.
You can expect to see more attention given to stress reduction techniques in the near future.