Workplace stress and its impact on the 16-year risk of myocardial infarction and stroke in an open female population aged 25-64 years in Russia/Siberia (WHO MONICA-psychosocial program)

Aim. To determine the impact of workplace stress on the hazard ratio (HR) of myocardial infarction (MI) and stroke in an open female population aged 25-64 years in Russia/Siberia (Novosibirsk) for 16 years. Subjects and methods. A random representative sample of 25-64-year-old women (n=870) residing in a Novosibirsk district was surveyed within the framework of the WHO "MONICA-psychological" program. Workplace stress was investigated using the Karasek scale; an attitude towards work and health prophylactic examinations was studied applying the Health Awareness and Attitude questionnaire of the WHO "MONICA-psychological" program. For 16 years (1994 to 2010), a cohort of all new cases of MI and stroke was examined employing the WHO Acute MI Registry program and all possible medical records. The Cox regression model was used to determine HR for MI and stroke in the open female population aged 25-64 years for 16 years. Results. The prevalence of high-level stress in the open female population aged 25-64 years was 31.6%. The high level of job stress was associated with a high responsibility, impossibility to have a rest at the end of a working day, frequent professional dissatisfaction, and a reduced work capacity. During 16 years, the women having high-level job stress showed a 3.22- and 1.96-fold increases in the HR of MI (p<0.05) and stroke (p<0.05), respectively. The incidence of MI and stroke was higher in married women expressing job stress as managers or manual laborers and having high and low educational attainment. Conclusion. The prevalence of high-level workplace stress was substantial in the open population of 25-64-year-old women in Russia/Siberia (Novosibirsk). The stress-related HR of MI and stroke was 3-2 times higher than in those without high-level stress. The HR of MI and stroke is affected by a social gradient.