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Int J Environ Res Public Health. 2018 Apr 2;15(4). pii: E659. doi: 10.3390/ijerph15040659.

Associations between Job Strain and Arterial Stiffness: A Large Survey among Enterprise Employees from Thailand.

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Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand.
Department of Environmental, Occupational and Geospatial Health Sciences, CUNY Institute for Implementation Sciences in Population Health, CUNY Graduate School of Public Health and Health Policy, New York, NY 10027, USA.
Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf 40225, Germany.


As an intermediate endpoint to cardiovascular disease, arterial stiffness has received much attention recently. So far, the research on work stress and arterial stiffness is still sparse and inconsistent, and no investigations on work stress and cardiovascular health among the Thai working population have been reported. Therefore, we conducted an epidemiological study among 2141 Thai enterprise employees (858 men and 1283 women) who were free from any diagnosed cardiovascular disease. Work stress was measured using Karasek's Job Demand-Control model for job strain (a combination of high demand and low control). Arterial stiffness was evaluated by a non-invasive approach using pulse-wave analysis based on a finger photoplethysmogram. Multivariable linear regression was applied to examine associations between job strain and arterial stiffness. In men, job strain was significantly associated with arterial stiffness (β  =  0.078, 95% confidence interval  =  0.026 to 0.130), after accounting for sociodemographic, behavioral, dietary and biomedical factors. However, the association in women was not significant. As the first study in Thailand on work stress and cardiovascular risk, we found that job strain might be an important risk factor for cardiovascular disease among Thai working men. Further studies with longitudinal design are warranted.


Thailand; cardiovascular risk; employees; gender; job strain

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