Job Strain and the Risk of Stroke: An Individual-Participant Data Meta-Analysis
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Background and Purpose—: Psychosocial stress at work has been proposed to be a risk factor for cardiovascular disease. However, its role as a risk factor for stroke is uncertain. Methods—: We conducted an individual-participant-data meta-analysis of 196 380 males and females from 14 European cohort studies to investigate the association between job strain, a measure of work-related stress, and incident stroke. Results—: In 1.8 million person-years at risk (mean follow-up 9.2 years), 2023 first-time stroke events were recorded. The age- and sex-adjusted hazard ratio for job strain relative to no job strain was 1.24 (95% confidence interval, 1.05;1.47) for ischemic stroke, 1.01 (95% confidence interval, 0.75;1.36) for hemorrhagic stroke, and 1.09 (95% confidence interval, 0.94;1.26) for overall stroke. The association with ischemic stroke was robust to further adjustment for socioeconomic status. Conclusion—: Job strain may be associated with an increased risk of ischemic stroke, but further research is needed to determine whether interventions targeting job strain would reduce stroke risk beyond existing preventive strategies.
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The association between poor social relationships and incident CVD is comparable in size to other recognised psychosocial risk factors, such as anxiety and job strain.
“We found an association between poor social relationships and incident CVD comparable in size to other recognised psychosocial risk factors, such as anxiety50 and job strain.51”
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- Authors
- Fransson, E. I., Nyberg, S. T., Heikkilä, K., Alfredsson, L., Bjorner, J. B., Borritz, M., Burr, H., Dragano, N., Geuskens, G. A., Goldberg, M., Hamer, M., Hooftman, W. E., Houtman, I. L., Joensuu, M., Jokela, M., Knutsson, A., Koskenvuo, M., Koskinen, A., Kumari, M., Leineweber, C., Lunau, T., Madsen, I. E. H., Hanson, L. L. M., Nielsen, M. L., Nordin, M., Oksanen, T., Pentti, J., Pejtersen, J. H., Rugulies, R., Salo, P., Shipley, M. J., Steptoe, A., Suominen, S. B., Theorell, T., Toppinen-Tanner, S., Vahtera, J., Virtanen, M., Väänänen, A., Westerholm, P. J. M., Westerlund, H., Zins, M., Britton, A., Brunner, E. J., Singh-Manoux, A., Batty, G. D., & Kivimäki, M.
- Affiliations
- Stockholm University (SE)
- From the Department of Natural Science and Biomedicine, School of Health Sciences, Jönköping University, Jönköping, Sweden (E.I.F.); Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (E.I.F., L.A.); Stress Research Institute, Stockholm University, Stockholm, Sweden (E.I.F., C.L., L.L.M.H., T.T., H.W.); Finnish Institute of Occupational Health, Tampere, Finland (S.T.N., K.H.); Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden ...
- ORCID
- Fransson, Eleonor I.
- Nyberg, Solja T.
- Heikkilä, Katriina
- Alfredsson, Lars
- Borritz, Marianne
- Burr, Hermann
- Goldberg, Marcel
- Hamer, Mark
- Houtman, Irene L.
- Joensuu, Matti
- Jokela, Markus
- Koskinen, Aki
- Leineweber, Constanze
- Lunau, Thorsten
- Madsen, Ida E.H.
- Hanson, Linda L. Magnusson
- Nielsen, Martin L.
- Oksanen, Tuula
- Pejtersen, Jan H.
- Rugulies, Reiner
- Salo, Paula
- Steptoe, Andrew
- Suominen, Sakari B.
- Theorell, Töres
- Vahtera, Jussi
- Virtanen, Marianna
- Väänänen, Ari
- Westerholm, Peter J.M.
- Westerlund, Hugo
- Zins, Marie
- Britton, Annie
- Brunner, Eric J.
- Batty, G. David
- Venue
- Stroke
- Published
- 2015-02
- Volume
- 46
- Issue
- 2
- Pages
- 557-559
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2136054938
- Cited by
- 130
- References
- 14
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 10 · 2023: 7 · 2022: 16 · 2021: 8 · 2020: 11 · 2019: 14 · 2018: 15 · 2017: 10 · 2016: 12 · 2015: 8 · 2012: 1
- FWCI
- 27.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
- Loughborough University Research Repository (Loughborough University) (submittedVersion, cc-by-nc-nd)
- Publications (Mid Sweden University) (submittedVersion, other-oa)
- Loughborough University Institutional Repository (Loughborough University) (submittedVersion, cc-by-nc-nd)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Open Access at Essex (University of Essex) (submittedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (submittedVersion)
- Funders
- National Research Centre
- Ministerie van Sociale Zaken en Werkgelegenheid
- British Heart Foundation (R01AG034454, K013351)
- Academy of Finland (K013351, R01 AG034454)
- Työsuojelurahasto
- Deutsche Gesetzliche Unfallversicherung
- Vetenskapsrådet (K013351)
- NordForsk (75021)
- Forskningsrådet om Hälsa, Arbetsliv och Välfärd
- National Institutes of Health
- Medical Research Council (MR/K013351/1, K013351, R01AG034454)
- Economic and Social Research Council (R01AG034454, ES/J023299/1, R01HL036310)
- National Institute on Aging (R01AG034454)
- National Heart, Lung, and Blood Institute (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
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- job strain, psychosocial stress, occupational stress, stroke risk, ischemic stroke, hemorrhagic stroke, cardiovascular disease, socioeconomic status
- MeSH terms
- Female, Humans, Individuality, Job Satisfaction, Male, Prospective Studies, Risk Factors, Stress, Psychological, Cohort Studies, Workload, Stroke
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