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Ann Med. 2015;47(6):512-8. doi: 10.3109/07853890.2015.1075658. Epub 2015 Sep 7.

The association between job strain and coronary heart disease: a meta-analysis of prospective cohort studies.

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a Shenzhen Psychiatric College, Anhui Medical University , Shenzhen, Guangdong , PR China.
b Department of Psychiatry , Shenzhen Key Laboratory of Psychological Health Center , Shenzhen, Guangdong , PR China.
c Department of Cardiology , the First People's Hospital of Shunde (the Affiliated Hospital at Shunde, Southern Medical University) , Foshan, Guangdong , China.
d Department of Medical Psychology , Anhui Medical University , Hefei, Anhui , PR China.
e School of Nursing, Anhui Medical University , Hefei, Anhui , PR China.



Studies about work stress and the risk of coronary heart disease (CHD) have yielded inconsistent results. This meta-analysis aimed to investigate the association between job strain and the risk of CHD.


We searched PubMed and Embase databases for studies reporting data on job strain and the risk of CHD. Studies were included if they reported multiple-adjusted relative risk (RR) with 95% confidence interval (CI) with respect to CHD from job strain.


Fourteen prospective cohort studies comprising 232,767 participants were included. The risk of CHD was increased in high-strain (RR 1.26; 95% CI 1.12-1.41) and passive jobs (RR 1.14; 95% CI 1.02-1.29) but not in active jobs (RR 1.09; 95% CI 0.97-1.22), when compared with low-strain group. The increased risk of CHD in high-strain and passive jobs was mainly driven by studies with a follow-up duration of ≥ 10 years. Neither the low-control (RR 1.06; 95% CI 0.93-1.19) nor high-demand (RR 1.13; 95% CI 0.97-1.32) dimension was independently associated with the risk of CHD.


Individuals with high-strain and passive jobs were more likely to experience a CHD event. Intervention programs incorporating individual and organizational levels are crucial for reducing job strain and the risk of CHD.


Coronary heart disease; job strain; meta-analysis; work stress

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