Associations of job strain and lifestyle risk factors with risk of coronary artery disease: a meta-analysis of individual participant data

被引：78

作者：

Kivimaki, Mika ^{[1
]}

Nyberg, Solja T. ^{[2
]}

Fransson, Eleonor I. ^{[3
,4
,6
]}

Heikkila, Katriina ^{[2
]}

Alfredsson, Lars ^{[4
,5
]}

Casini, Annalisa

Clays, Els ^{[8
]}

De Bacquer, Dirk ^{[8
]}

Dragano, Nico

Ferrie, Jane E. ^{[1
]}

Goldberg, Marcel

Hamer, Mark ^{[1
]}

Jokela, Markus ^{[10
]}

Karasek, Robert

Kittel, France ^{[7
]}

Knutsson, Anders ^{[12
]}

Koskenvuo, Markku ^{[11
]}

Nordin, Maria ^{[13
]}

Oksanen, Tuula ^{[2
]}

Pentti, Jaana ^{[2
]}

Rugulies, Reiner ^{[14
]}

Salo, Paula ^{[2
,15
]}

Siegrist, Johannes ^{[9
]}

Suominen, Sakari B. ^{[16
]}

Theorell, Tores ^{[6
]}

Vahtera, Jussi ^{[6
,16
,17
]}

Virtanen, Marianna ^{[2
]}

Westerholm, Peter J. M. ^{[18
]}

Westerlund, Hugo

Zins, Marie

Steptoe, Andrew ^{[1
]}

Singh-Manoux, Archana ^{[1
]}

Batty, G. David ^{[19
]}

机构：

[1] UCL, Dept Epidemiol & Publ Hlth, London, England

[2] Ctr Expertise Dev Work & Organizat, Helsinki, Finland

[3] Jonkoping Univ, Finnish Inst Occupat Hlth, Jonkoping, Sweden

[4] Inst Environm Med, Stockholm, Sweden

[5] Ctr Occupat & Environm Med, Stockholm, Sweden

[6] Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden

[7] Univ Libre Bruxelles, Sch Publ Hlth, Brussels, Belgium

[8] Univ Ghent, Dept Publ Hlth, Ghent, Belgium

[9] Univ Dusseldorf, Dept Med Sociol, Dusseldorf, Germany

[10] Univ Helsinki, Inst Behav Sci, Helsinki, Finland

[11] Univ Helsinki, Dept Publ Hlth, Helsinki, Finland

[12] Mid Sweden Univ, Dept Hlth Sci, Sundsvall, Sweden

[13] Umea Univ, Dept Psychol, Umea, Sweden

[14] Working Environm, Natl Res Ctr, Copenhagen, Denmark

[15] Univ Turin, Dept Psychol, Turku, Finland

[16] Univ Turin, Dept Publ Hlth, Turku, Finland

[17] Turku Univ Hosp, Turku, Finland

[18] Uppsala Univ, Uppsala, Sweden

[19] Univ Edinburgh, Ctr Cognit Ageing & Cognit Epidemiol, Edinburgh, Midlothian, Scotland

来源：

CANADIAN MEDICAL ASSOCIATION JOURNAL | 2013年 / 185卷 / 09期

基金：

芬兰科学院;

关键词：

SMOKING-CESSATION INTERVENTION; HEART-DISEASE; MYOCARDIAL-INFARCTION; CARDIOVASCULAR-DISEASE; PHYSICAL-ACTIVITY; BLOOD-PRESSURE; 52; COUNTRIES; WORK STRESS; WEIGHT-LOSS; FOLLOW-UP;

D O I：

10.1503/cmaj.121735

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: It is unclear whether a healthy lifestyle mitigates the adverse effects of job strain on coronary artery disease. We examined the associations of job strain and lifestyle risk factors with the risk of coronary artery disease. Methods: We pooled individual-level data from 7 cohort studies comprising 102 128 men and women who were free of existing coronary artery disease at baseline (1985-2000). Questionnaires were used to measure job strain (yes v. no) and 4 lifestyle risk factors: current smoking, physical inactivity, heavy drinking and obesity. We grouped participants into 3 lifestyle categories: healthy (no lifestyle risk factors), moderately unhealthy (1 risk factor) and unhealthy (2-4 risk factors). The primary outcome was incident coronary artery disease (defined as first nonfatal myocardial infarction or cardiac-related death). Results: There were 1086 incident events in 743 948 person-years at risk during a mean follow-up of 7.3 years. The risk of coronary artery disease among people who had an unhealthy lifestyle compared with those who had a healthy lifestyle (hazard ratio [HR] 2.55, 95% confidence interval [CI] 2.18-2.98; population attributable risk 26.4%) was higher than the risk among participants who had job strain compared with those who had no job strain (HR 1.25, 95% CI 1.06-1.47; population attributable risk 3.8%). The 10-year incidence of coronary artery disease among participants with job strain and a healthy lifestyle (14.7 per 1000) was 53% lower than the incidence among those with job strain and an unhealthy lifestyle (31.2 per 1000). Interpretation: The risk of coronary artery disease was highest among participants who reported job strain and an unhealthy lifestyle; those with job strain and a healthy lifestyle had half the rate of disease. A healthy life style may substantially reduce disease risk among people with job strain.

引用

页码：763 / 769

页数：7

共 38 条

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