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 lifestyle may substantially reduce disease risk among people with job strain.
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 lifestyle may substantially reduce disease risk among people with job strain.
Authors: K Korkeila; S Suominen; J Ahvenainen; A Ojanlatva; P Rautava; H Helenius; M Koskenvuo Journal: Eur J Epidemiol Date: 2001 Impact factor: 8.082
Authors: Dirk De Bacquer; E Pelfrene; E Clays; R Mak; M Moreau; P de Smet; M Kornitzer; G De Backer Journal: Am J Epidemiol Date: 2005-03-01 Impact factor: 4.897
Authors: Nicholas R Anthonisen; Melissa A Skeans; Robert A Wise; Jure Manfreda; Richard E Kanner; John E Connett Journal: Ann Intern Med Date: 2005-02-15 Impact factor: 25.391
Authors: Salim Yusuf; Steven Hawken; Stephanie Ounpuu; Leonelo Bautista; Maria Grazia Franzosi; Patrick Commerford; Chim C Lang; Zvonko Rumboldt; Churchill L Onen; Liu Lisheng; Supachai Tanomsup; Paul Wangai; Fahad Razak; Arya M Sharma; Sonia S Anand Journal: Lancet Date: 2005-11-05 Impact factor: 79.321
Authors: V J Stevens; E Obarzanek; N R Cook; I M Lee; L J Appel; D Smith West; N C Milas; M Mattfeldt-Beman; L Belden; C Bragg; M Millstone; J Raczynski; A Brewer; B Singh; J Cohen Journal: Ann Intern Med Date: 2001-01-02 Impact factor: 25.391
Authors: Judith E Neter; Bianca E Stam; Frans J Kok; Diederick E Grobbee; Johanna M Geleijnse Journal: Hypertension Date: 2003-09-15 Impact factor: 10.190
Authors: Joep Perk; Guy De Backer; Helmut Gohlke; Ian Graham; Zeljko Reiner; Monique Verschuren; Christian Albus; Pascale Benlian; Gudrun Boysen; Renata Cifkova; Christi Deaton; Shah Ebrahim; Miles Fisher; Giuseppe Germano; Richard Hobbs; Arno Hoes; Sehnaz Karadeniz; Alessandro Mezzani; Eva Prescott; Lars Ryden; Martin Scherer; Mikko Syvänne; Wilma J M Scholte op Reimer; Christiaan Vrints; David Wood; Jose Luis Zamorano; Faiez Zannad Journal: Eur Heart J Date: 2012-05-03 Impact factor: 29.983
Authors: M G Marmot; G D Smith; S Stansfeld; C Patel; F North; J Head; I White; E Brunner; A Feeney Journal: Lancet Date: 1991-06-08 Impact factor: 79.321