Work-related Stress Increases Risk for Peripheral Artery Disease Hospitalization

A new study in the Journal of the American Heart Association highlighted a link between stress caused by work and an increased risk for hospitalization for peripheral artery disease (PAD).

“Recent large‐scale observational ‘mega‐studies’ have shown that stress is associated with many cardiovascular outcomes, most strongly as a trigger or a prognostic factor for major cardiac events in high‐risk populations and in those with pre‐existing cardiovascular disease,” the authors wrote in their study. “Reflecting this evidence, European clinical guidelines now recognize psychosocial stress as an important clinical target in the management of heart disease and stroke. However, in contrast to the extensive research into the associations of various stress exposures with myocardial infarction, stroke, atrial fibrillation, and venous thromboembolism, few studies have examined the relationship between stress and PAD.”

To do this, the authors looked at 11 prospective cohort studies (conducted in Finland, Sweden, Denmark, and the UK) measuring self-reported job strain (high demands and low control) and compared them with hospital records of PAD between 1985 and 2008. The authors then used Cox regression to look at the link between PAD and job strain in each cohort study. The analysis sample included more than 139,000 (n=139,132) participants with no previous history of hospitalization for PAD. Of those, 32,489 (23.4%) reported job strain at baseline.

According to the study results, during 1,718,132 person-years at risk, 667 participants had record of hospitalization for PAD (3.88 per 10,000 person years). Job strain was linked with a 1.41-fold increase in the risk for hospitalization for PAD (95% CI, 1.11 to 1.80). These estimates were consistent across both sexes, socioeconomic status, and baseline smoking status. Adjustment for baseline diabetes did not alter the association.

Study limitations included hospital-treated PAD only, reducing the ability to generalize to less sever forms of PAD. There were also data, such as blood pressure and cholesterol levels, that were unavailable.

“Our findings suggest that work-related stress may be a risk factor for peripheral artery disease in a similar way as it is for heart disease and stroke,” said lead study author Katriina Heikkilä, PhD, senior researcher at the Karolinska Institute, Stockholm, said in a press release.