Associations of Job Strain, Stressful Life Events, and Social Strain With Coronary Heart Disease in the Women’s Health Initiative Observational Study

Author:

Wang Conglong1,Lê‐Scherban Félice1,Taylor Jennifer1ORCID,Salmoirago‐Blotcher Elena2ORCID,Allison Matthew3,Gefen David4,Robinson Lucy1,Michael Yvonne L.1ORCID

Affiliation:

1. Dornsife School of Public Health Drexel University Philadelphia PA

2. The Miriam Hospital Centers for Behavioral and Preventive Medicine Warren Alpert School of Medicine of Brown University Providence RI

3. University of California, San Diego La Jolla CA

4. LeBow College of Business Drexel University Philadelphia PA

Abstract

Background The association between psychosocial stress and coronary heart disease (CHD) may be stronger in women than men and may differ across types of stressors. In this study, we assessed associations of psychosocial stressors, including job strain, stressful life events, and social strain with the incidence of CHD in women. Methods and Results We used longitudinal data from 80 825 WHI‐OS (Women's Health Initiative Observational Study) participants with a mean age of 63.4 years (7.3 years) at baseline. Job strain was assessed through linkage of Standard Occupational Classification codes to the Occupational Information Network. Stressful life events and social strain were assessed via validated self‐reported questionnaires. Cox proportional hazard models were used to evaluate associations of each stressor with CHD separately and jointly. A total of 3841 (4.8%) women developed CHD during an average of 14.7 years of follow‐up. After adjustment for age, other stressors, job tenure, and socioeconomic factors, high stressful life events score was associated with a 12% increased CHD risk, and high social strain was associated with a 9% increased CHD risk. Job strain was not independently associated with CHD risk, but we observed a statistically significant interaction between job strain and social strain ( P =0.04), such that among women with high social strain, passive job strain was associated with a 21% increased CHD risk. Conclusions High stressful life events and social strain were each associated with higher CHD risk. Job strain and social strain work synergistically to increase CHD risk.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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