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In study, work stress linked to stroke risk


High-stress jobs are known to be associated with increased risk of cardiovascular disease. A research study published last week in the journal Neurology now indicates that work stress also increases the risk of stroke, especially for women.

Dingli Xu, MD, and his research team from Southern Medical University in Guangzhou, China performed a comprehensive statistical analysis of six previous research studies on job stress and stroke risk; the studies included a total of 138,782 participants who were followed for three to 17 years. For the work they classified jobs into one of our four categories, based on the amount of control workers have over their jobs and the psychological demand of their jobs:

  • Passive jobs with low control and low demand, such as janitors and other manual laborers
  • Low-stress jobs with high control and low demand, such natural scientists and architects
  • High-stress jobs with low control and high demand, such as waitresses and nursing aids
  • Active jobs with high control and high demand, such as physicians, teachers and engineers

Xu's team determined that people with high-stress jobs had a 22 percent increased risk of all types of stroke compared to people with low-stress jobs, while there was no increased relative risk of stroke for people with passive or active jobs. The increased risk associated with a high-stress job compared to a low-stress one was found to be even greater at 58 percent for ischemic strokes, the most common type of stroke.

Analyses were also performed separately for women and men, including more than 126,459 women and only 12,323 men. Women with high-stress jobs had a 33 percent higher risk of all types of stroke than women with low-stress jobs. However, no significant increase in relative stroke risk was seen for men with high-stress jobs, most likely due to the limited number of men included in the studies.

Similarly, the researchers calculated the increased incidence of stroke in the population associated with high-stress jobs to be 4.4 percent overall and 6.5 percent for women.

Unfortunately the cause of this increased stroke risk is still a mystery. University of Utah's Jennifer Majersik, MD, MS, commented on Xu’s research study in an editorial, writing,“Why do high strain jobs cause an increased risk of stroke? The simplest answer is that we do not know.”

This new study, though, has at least provided some clinical guidance. As a stroke neurologist, Majersik is often asked by patients whether stress caused their stroke, and she hasn’t known how to answer. But, she writes, "I will now say ‘maybe’ and then specifically discuss their job type and structure. This is important because there may be ways to reduce job strain, without losing the job."

Organizations can help employees increase job control and reduce job demand in some simple ways, such as embracing flexible work arrangements like telecommuting. The authors believe successful interventions could have a major impact on public health.

Jennifer Huber, PhD, is a science writer with extensive technical communications experience as an academic research scientist, freelance science journalist, and writing instructor. 

Previously: Workplace stress and how it influences healthHow work stress affects wellness, health-care costs and BE FAST: Learn to recognize the signs of stroke
Photo by William Brawley

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