Associations of job strain and lifestyle risk factors with risk of coronary artery disease: a meta-analysis of individual participant data
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Key result
Participants who reported both job strain and an unhealthy lifestyle had the highest risk of coronary artery disease (HR 2.69), whereas a healthy lifestyle was associated with a 53% lower incidence of disease among those with job strain.
Why the study?
Does a healthy lifestyle reduce the risk of incident coronary artery disease in people with job strain?
Population
102,128 men and women free of existing coronary artery disease at baseline pooled from 7 European…
Comparison
Job strain combined with an unhealthy lifestyle vs No job strain combined with a healthy lifestyle
Design
Meta-analysis
Follow-up
mean 7.3 years
Authors
Discussion
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Member takes
Implication
Healthy lifestyle may halve CAD risk with job strain; supports targeted prevention but leaves open need for RCTs.
Study Design
Type
Meta-Analysis (n=102,128)
Multicenter
Yes
Structured PICO
Does a healthy lifestyle reduce the risk of incident coronary artery disease in people with job strain?
P
Population
102,128 men and women (mean age 44.3 years, 51.8% female) free of existing coronary artery disease at baseline, followed for a mean of 7.3 years.
E
Exposure
Job strain combined with an unhealthy lifestyle (defined as 2-4 risk factors: current smoking, physical inactivity, heavy drinking, obesity)
C
Comparator
No job strain combined with a healthy lifestyle (0 lifestyle risk factors)
O
Outcome
Incident coronary artery disease (defined as first nonfatal myocardial infarction or cardiac-related death)hard clinical
Main Result
Hazard Ratio: 2.69 (95% CI 1.94–3.73)
Absolute Event Rate: 31.2% vs 11.6%
A healthy lifestyle is associated with a substantially reduced risk of coronary artery disease among individuals experiencing job strain, halving the rate of disease compared to those with an unhealthy lifestyle.
Limitations
- Self-reported measures of job strain and lifestyle factors (smoking, alcohol intake, physical activity) may have led to misclassification.
- Observational design precludes conclusions about causal associations due to potential residual or unmeasured confounding.
- Self-reported job strain and lifestyle indicators leading to potential misclassification
- Observational data precluding conclusions about causal associations due to potential residual or unmeasured confounding
Cite This Study
Kivimäki et al. (2013) conducted a meta-analysis in Coronary artery disease (n=102,128). Job strain and an unhealthy lifestyle (2-4 risk factors) vs. No job strain and a healthy lifestyle (0 risk factors) was evaluated on Incident coronary artery disease (first nonfatal myocardial infarction or cardiac-related death) (HR 2.69, 95% CI 1.94-3.73). Participants who reported both job strain and an unhealthy lifestyle had the highest risk of coronary artery disease (HR 2.69), whereas a healthy lifestyle was associated with a 53% lower incidence of disease among those with job strain.
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