Key result
Prolonged emotional strain associated with occupational responsibilities preceded the attack in 91% of patients with coronary heart disease versus 20% of controls (ratio 4.6).
Why the study?
What is the relative importance of emotional stress, diet, tobacco, heredity, obesity, and lack of physical exercise in causing coronary heart disease?
Case-Control (n=200)
What is the relative importance of emotional stress, diet, tobacco, heredity, obesity, and lack of physical exercise in causing coronary heart disease?
Effect estimate: Ratio 4.6
Absolute Event Rate: 91% vs 20%
Emotional stress associated with occupational responsibilities appears to be a major risk factor for coronary heart disease, potentially more significant than diet, tobacco, or heredity in this cohort.
Supports hypothesis that occupational emotional strain triggers CHD events; leaves open its relative importance to diet, tobacco, heredity, obesity, and inactivity.
A period of prolonged emotional strain associated with occupational responsibilities preceded the attack in 91 of 100 patients with coronary heart disease. In a comparable series of 100 patients with other diseases, only 20 had undergone this kind of strain. The pattern of insecurity, frustration, and restlessness extended beyond the primary vocation into secondary occupations and leisure activities. Taking 91/20 or 4.6 as a ratio measuring the importance of occupational stress, the author obtains comparable ratios of 2.7 for diet, 2.0 for tobacco, 1.7 for heredity, 1.3 for obesity, and 1.0 for lack of physical exercise as suggesting the relative importance of these factors in causing coronary heart disease in this group of patients.
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Henry I. Russek (1959) conducted a case-control in Coronary heart disease (n=200). Prolonged emotional strain (occupational stress) vs. Absence of prolonged emotional strain was evaluated on Coronary heart disease (Ratio 4.6). Prolonged emotional strain associated with occupational responsibilities preceded the attack in 91% of patients with coronary heart disease versus 20% of controls (ratio 4.6).
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