Associations between the effort-reward imbalance model of workplace stress and indices of cardiovascular health: A systematic review and meta-analysis.

Work stress can increase the risk of cardiovascular disease by 50%, with increasing research focusing on the underlying mechanisms responsible for these associations. Our meta-analysis assessed the associations of the effort-reward imbalance (ERI) workplace stress model with indices of cardiovascular disease. The search term 'effort*reward*imbalance' produced 22 papers (129 associations, N=93,817) meeting inclusion criteria. Greater ERI was most associated with increased hypertension (r=0.26, p<0.001, N=1180), intima media thickness (r=0.23, p<.001, N=828) and fibrinogen (r=0.13, p=0.03, N=4315). Trait over-commitment was most associated with increased hypertension (r=0.24, p=0.02, N=899) and intima media thickness (r=0.19, p=0.02, N=828). Interventions aimed at reducing the impact of ERI and over-commitment on cardiovascular disease should consider concurrently assessing changes in physiological markers of cardiovascular disease.