Chronic stress at work and the metabolic syndrome: prospective study
Open accessAbstract
OBJECTIVES: To investigate the association between stress at work and the metabolic syndrome. [table: see text]. DESIGN: Prospective cohort study investigating the association between work stress and the metabolic syndrome. PARTICIPANTS: 10 308 men and women, aged 35-55, employed in 20 London civil service departments at baseline (the Whitehall II study); follow-up was an average of 14 years. MAIN OUTCOME MEASURES: Work stress based on the iso-strain model, measured on four occasions (1985-99). Biological measures of the metabolic syndrome, based on the National Cholesterol Education Program definition, measured in 1997-9. RESULTS: A dose-response relation was found between exposure to work stressors over 14 years and risk of the metabolic syndrome, independent of other relevant risk factors. Employees with chronic work stress (three or more exposures) were more than twice as likely to have the syndrome than those without work stress (odds ratio adjusted for age and employment grade 2.25, 95% confidence interval 1.31 to 3.85). CONCLUSIONS: Stress at work is an important risk factor for the metabolic syndrome. The study provides evidence for the biological plausibility of the link between psychosocial stressors from everyday life and heart disease.
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Stress is an independent risk factor for illness and even mortality.
“stress is an independent risk factor for illness and even mortality [5–7].”
From A pilot randomised trial comparing a mindfulness-based stress reduction course, a locally-developed stress reduction intervention and a waiting list control group in a real-life municipal health care setting (2020) · cites this paper as [6]
The Conclusions (page not supplied) report that employees with chronic work stress had more than double the odds of metabolic syndrome after other risk factors were taken into account. This supports an adjusted association with a specific health condition, but the paper does not establish stress as a risk factor for illness generally or report stress-related mortality. (LLM, conf=0.87)
Experimental — accuracy not yet measuredPsychological stressors that persist in some contemporary work environments, such as high job demand and low control, can cause physiological changes that impair glucocorticoids' ability to down-regulate inflammatory activity because chronic cortisol elevation reduces sensitivity, leading to SCI and poor health.
“psychological stressors that are persistently present in some contemporary work environments, such as those characterized by high job demand and low control, can cause physiologic changes155 that disrupt the ability for glucocorticoids to effectively down-regulate inflammatory activity due to decreased sensitivity caused by chronic elevation in cortisol, leading in turn to SCI and poor health156”
From Chronic inflammation in the etiology of disease across the life span (2019) · cites this paper as [155]
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- Authors
- Chandola, T., Brunner, E., & Marmot, M.
- Affiliations
- University College London (GB)
- Corresponding author
- Chandola, Tarani
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2006-01-20
- Volume
- 332
- Issue
- 7540
- Pages
- 521-525
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC1388129
- OpenAlex
- W2140275529
- Cited by
- 1,075
- References
- 26
- Citations by year
- 2026: 32 · 2025: 26 · 2024: 33 · 2023: 36 · 2022: 54 · 2021: 38 · 2020: 63 · 2019: 63 · 2018: 68 · 2017: 59 · 2016: 63 · 2015: 55 · 2014: 78 · 2013: 69 · 2012: 53
- FWCI
- 110.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- John D. and Catherine T. MacArthur Foundation (HS06516)
- British Heart Foundation (HS06516)
- Health and Safety Executive
- National Institutes of Health
- Agency for Healthcare Research and Quality (HS06516)
- Medical Research Council (HS06516)
- Economic and Social Research Council
- National Institute on Aging (AG 13196)
- National Heart, Lung, and Blood Institute (HL36310, R01HL036310)
- Topics
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- chronic occupational stress, metabolic syndrome, psychosocial stressors, dose-response relationship, cardiovascular risk factors, heart disease, civil service employees, Whitehall II study
- MeSH terms
- Adult, Chronic Disease, Female, Follow-Up Studies, Heart Diseases, Humans, Male, Middle Aged, Occupational Diseases, Prospective Studies, Stress, Psychological, Cohort Studies, Metabolic Syndrome
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