The possible relationship of occupational stress to clinical coronary heart disease.

Perhaps because of difficulties inherent in quantitation and evaluation, the possible influence of differences in personality factors and of socio-economic stresses has largely been ignored in epidemiological studies of coronary artery disease. This relationship is explored and it is shown that the major factors contributing to the development of coronary disease, including intimal damage, elevated plasma lipid content, altered hemodynamics and accelerated blood clotting, are each affected by certain types of such stresses. On the basis of the considerable clinical and experimental evidence cited, it is suggested that the increasing occupational stress unique to industrialized society plays a dominant role in the high incidence of clinical coronary heart disease.