By Amanda Gardner
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After a bad day at work, do you ever complain to your friends that
your high-pressure job or demanding boss is giving you a heart attack?
It’s just a figure of speech, but you might actually be on to something.
According to a new study of more than 22,000 female doctors and
nurses, being in a stressful work situation increases a woman’s risk of
heart attacks and related problems, possibly because the stress
contributes to high blood pressure and other hazards.
Women who reported high levels of job strain were two-thirds more
likely to have a heart attack during a 10-year period compared with
women in easygoing jobs, the study found. Women in high-strain jobs were
also 41% more likely to require a heart procedure such as bypass
surgery.
Job strain isn’t exactly the same as job stress. When researchers
talk about job strain, they’re referring to a specific type of
psychological stress that’s “basically a combination of how demanding
one’s job is and how much control one has over one’s job,” says Michelle
Albert, M.D., the senior author of the study.
Challenging, fast-paced jobs aren’t necessarily straining.
High-strain jobs are very demanding, yet they also involve little
control or authority (picture working 12-hour days while being
micromanaged). Low-strain jobs, on the other hand, feature relatively
few demands and high levels of day-to-day control.
Chronic stress can lead to anxiety and depression, both of which have
been linked to heart disease. In this study, though, anxiety and
depression—along with other risk factors, such as smoking and body mass
index—contributed only slightly to the relationship between job strain
and heart attacks, suggesting that other factors were at play.
One likely explanation, Albert says, is that job strain leads to
over-activation of the body’s stress system, including the release of
stress hormones. This can lead to higher blood pressure, insulin
resistance, and other processes that damage the blood vessels and heart.
“Stress is normal, except when it overpowers our body’s ability to
adapt to the stressor—and that’s what we’re talking about here,” says
Albert, a Harvard Medical School professor and cardiologist at Brigham
& Women’s Hospital, in Boston.
Albert and her colleagues were somewhat surprised to find that women
with high-demand, high-control jobs had elevated heart risk, too. This
type of job—managerial positions, for instance—aren’t considered
high-strain, so it could be that they breed a different kind of stress.
It can be lonely at the top, and women who find themselves with a lot
of responsibility and authority may be more isolated, Albert says.
Feelings of loneliness and a lack of social support have both been shown
in previous studies to contribute to a higher risk of heart disease.
Interestingly, worrying about losing your job—a common source of
work-related stress—wasn’t linked at all with heart disease in the
study. But that could just be a quirk of the study population, and may
not be true across all industries.
“The group of women studied here are health care professionals,”
Albert says. “In the current economic climate, health care jobs tend to
be a little bit more stable.”
The findings may not apply to everyone, in other words, and they
don’t necessarily capture the myriad other sources of stress that can
affect health, such as owing money or losing a loved one. All that
remains to be worked out in future research.
“We live in an environment where you just don’t have one type of
stressor,” Albert says. “You have multiple types of stress, so there’s a
great need to look at the joint impact of different stressors on
cardiovascular disease.”
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