8–1.3) m 1.1 (1.0–1.2) stroke f 0.9 (0.7–1.1) m 1 (0.9–1.1) Age, education, self-reported health Matthews (2002) MRFIT USA 2− 12,336 35–57 years 771 cases 9 years Presence of >3 of the following items: new APO866 manufacturer workplace, demotion, business failure, troubles with colleagues, disability, being fired CVD, morbidity and mortality m 1.34 (1.07–1.67) Age, study group, biological risk factors
Suadicani (1993) Copenhagen male study Denmark 2− 1,638 55–47 years 46 cases 4 years Work pace too fast, little influence on job organisation CHD, morbidity and mortality m p > 0.05 No adjustment Theorell (1977) Sweden 2− 5,187 41–61 years 31 cases 2 years Workload index: includes items to responsibilities, problems with workmates, unemployment or changes in type of work CHD morbidity and mortality m p < 0.01 Age Netterström (1988) check details Denmark 2− 2,045 20–64 years 89 cases 8 years ‘Suffering from stress several times a months’ CHD, morbidity and mortality m 1.1 (0.7–1.8) Age, smoking aName of the cohort, if applicable bModified version of the Scottish Intercollegiate Guidelines Network (SIGN)
checklist for cohort studies (Harbour and Miller 2001) c CHD coronary heart disease (myocardial infarction, angina), CVD cardiovascular disease dSignificant (p < 0.05, CI excluding 1) results in bold letters. f female, m male, n.s. not significant. Risk estimates for job strain were calculated by comparing the high-strain group with the low-strain group (exception Eaker et al.: high-strain group is the reference group). In most cases, hazard ratios or relative PRIMA-1MET risks were Thalidomide estimated, and in case of other statistical analyses, p values or level of significance is indicated eBlood pressure,
and/or lipids, and/or fibrinogen and/or BMI, and/or diabetes are considered as biological risk factors. Smoking, and/or alcohol, and/or low physical activity are considered as behavioural risk factors. SBP systolic blood pressure, DBP diastolic blood pressure, BMI body mass index, LDL low-density lipoprotein In the majority of the cohorts, participants were recruited from an unselected general working population. The remaining studies included selected occupations or companies (see Tables 1, 2, 3 for details). Nine cohorts investigated only men and three cohorts only women. Twelve publications (eight cohorts) described both men and women. Ten of the 15 analyses examining only male participants yielded significant positive results, whereas only one of the nine analyses observing exclusively women showed significant positive results. In summary, statistically significant associations between psychosocial stress and cardiovascular disease were described in 14 out of 26 publications (11 out of 20 cohorts, respectively). With the exception of the Nurses Health Study (Lee et al. 2002), all studies that reported risk estimates indicated a higher risk of cardiovascular diseases with increasing stress. However, not all of these results were statistically significant.