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).
Case-Control (n=200)
200 patients, comprising 100 with coronary heart disease and 100 with other diseases, evaluated for preceding emotional strain and other risk factors.
Prolonged emotional strain (occupational stress) vs Absence of prolonged emotional strain
Coronary heart disease — Ratio 4.6
Effect estimate: Ratio 4.6
Absolute Event Rate: 91% vs 20%
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
United States Public Health Service
Journal of the American Medical Association
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Henry I. Russek (Sat,) 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).
synapsesocial.com/papers/6a1f4c232865985bbe2aad73 — DOI: https://doi.org/10.1001/jama.1959.03010230001001