Work-related stress linked to serious heart condition

New research reveals that work-related stress caused by job strain and an imbalance between efforts applied and rewards received can increase the risk of developing atrial fibrillation. This condition is characterized by an irregular (often rapid) heartbeat that commonly causes poor blood flow. 

Atrial fibrillation (also known as AFib or AF) is the most frequent form of arrhythmia and can lead to stroke, heart failure and other cardiovascular problems. Over 12 million people are projected to have atrial fibrillation in the United States by 2030.

Work-related stress and atrial fibrillation 

Previous studies connected high job strain and effort-reward imbalance at work with an increased risk of coronary heart disease. However, this research is the first to investigate the adverse effect of these psychosocial stressors at work on atrial fibrillation. 

Study senior author Dr. Xavier Trudel is an occupational and cardiovascular epidemiologist and associate professor at Laval University in Canada.

“Our study suggests that work-related stressors may be relevant factors to include in preventive strategies,” said Dr. Trudel. 

“Recognizing and addressing psychosocial stressors at work are required to foster healthy work environments that benefit both individuals and the organizations where they work.”

Job strain and effort-reward imbalance 

The experts examined the impact of job strain, which refers to a work environment in which employees struggle with high job demands, such as a heavy workload and tight deadlines, along with low control over their work and lack of decision-making in how they execute their work-related tasks.

Another factor assessed was the effort-reward imbalance. This phenomenon occurs when employees invest major efforts into their work but perceive the rewards they get for this work  (such as salary, recognition, or job security) as or unequal to their performance.

Heart impacts of work-related stress 

By examining medical database records for almost 6,000 adults in white-collar jobs in Canada, with 18 years of follow-up data, the researchers found that employees experiencing high job strain had an 83% higher risk of developing atrial fibrillation than workers unaffected by such stressors.

The experts also found that those who experienced an effort-reward imbalance had a 44% greater risk than workers who did not report this imbalance.

Furthermore, the study showed that combined experiences of high job strain and effort-reward imbalance were linked to a 97% increased risk of AFib.

Further research is needed

According to Dr. Trudel, the effectiveness of workplace interventions to reduce psychosocial stressors that may also reduce the risk of AFib should be investigated in future research. 

“Our research team previously conducted an organizational intervention designed to reduce psychosocial stressors at work, which was shown to effectively reduce blood pressure levels,” said Dr. Trudel. 

“Examples of organizational changes implemented during the intervention included slowing down the implementation of a large project to prevent increased workload; implementing flexible work hours; and holding meetings between managers and employees to discuss day-to-day challenges.”

Some of the limitations of this study include that all participants were white-collar workers in Canada, which means that the results may not apply to other types of workers or to workers in other countries.

Study details and background 

The scientists collected data through the PROspective Quebec (PROQ) Study on Work and Health, which was initiated in the Quebec region in 1991-1993 and recruited white-collar workers from 19 public and semi-public organizations.

The analysis was focused on 5,926 workers (49% men, 51% women), with an average age of 45 at the beginning of the study (1999-2001) and 65 at the end of the follow-up (Dec. 2018), were included. Levels of work stress were assessed through self-reported questionnaires. 

The experts controlled for a broad number of socioeconomic characteristics (sex, education), health risks (diabetes, high blood pressure) and lifestyle factors (smoking, drinking alcohol).

Overall, the researchers identified 186 AFib cases. Among that group, 19% reported high job strain, 25% reported effort-reward imbalance, and 10% reported experiencing both of  these stressors at the same time.

The study showed that over one third of all participants had been diagnosed with coronary heart disease or heart failure before developing AFib.

The research is published in the Journal of the American Heart Association. 

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