Having a demanding job and little control over it is associated with an increased risk of premature death in men with cardiometabolic disease, according to a 14-year observational study of more than 100,000 people published in June 2018.
However, the same cannot be said for women who are stressed at work, with no evidence to suggest it could shorten their lives — whether they have cardiometabolic disease or not.
So, what is cardiometabolic disease? In simple terms it is combination of insulin resistance and impaired glucose usage and is closely linked to overweight or obesity and inactivity.
The research in the Lancet Diabetes and Endocrinology study includes two types of work stress: job strain (having high work demands and low control over them) and effort–reward imbalance (putting in lots of effort but getting little reward in return).
After controlling for socioeconomic status and several conventional and lifestyle risk factors — including hypertension, hyperlipidaemia, smoking, obesity, physical inactivity and high alcohol consumption — the authors found that among men with cardiometabolic disease, those experiencing job strain have a 68% greater risk of premature death than men with no job strain.
In addition, this increased risk is even present in men with cardiometabolic disease who have achieved their treatment targets, including those with a healthy lifestyle, and good blood pressure and cholesterol levels.
Neither type of work stress is associated with increased mortality risk for women, with or without cardiometabolic disease.
The authors say that job stress may affect the body in a number of ways to cause this association, including hijacking natural responses to stress through heightened levels of the stress hormone cortisol, which increases glucose production and limits the effect of insulin, potentially leading to a worse prognosis in diabetes.
In addition, increased inflammation and activation of the fight-or-flight response can elevate blood pressure and affect blood clotting, potentially increasing the risk of cardiac events in individuals who already have high levels of hardening of the arteries.
Professor Mika Kivimäki from University College London says the findings suggest that controlling blood pressure and cholesterol levels alone are unlikely to eliminate the excess risk associated with job strain in men with cardiometabolic disease.
When you have a personal toolkit of simple, sustainable, selfcare techniques, tools and strategies to support you in times of stress at work, at home, in your relationships and all other areas of your life, your wellbeing index is very positive.
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