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Association between job strain and risk of incident stroke

A meta-analysis

  1. Dingli Xu, MD
  1. From the Department of Cardiology (Y. Huang, J.H., D.Z., C.L., D.X.), Nanfang Hospital, Southern Medical University, Guangzhou; Shenzhen Psychiatric College (S.X.), Anhui Medical University; Department of Psychiatry (S.X., T.L.), Shenzhen Key Laboratory of Psychological Health Center, Shenzhen; and Clinical Medicine Research Center (Y. Huang, Y. Hu), the First People's Hospital of Shunde, Foshan, PR China.
  1. Correspondence to Dr. Dingli Xu: dinglixu{at}fimmu.com or Dr. Tiebang Liu: liutbsz{at}sina.com
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  1. (1) Research support from Health Ministry of Guangdong province, China, No: A2012663, not relevant to this study, years: 2012-2014 (2) Scientific Research Fund of Foshan, Guangdong, China, No:201208210, not relevant to this study, years: 2012-2014

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  1. Guangdong Provincial Science and Technology projects. No:93102.Not relevant to this paper. Year:2009-2013

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Research Support, Government Entities:

  1. (1) Natural Science Foundation of Guangdong Province, No.8151051501000048, not relevant to this study, years: 2010-2012 (2) Guangdong Provincial Science and Technology projects, No.2009B030801204, No.2012B031800184, not relevant to this study, years: 2010-2012 (3) Guangzhou City Science and Technology projects , No.2010YC181, not relevant to this study, years: 2011-2013 (4) National Natural Science Foundation of China, No.81270320, not relevant to this study, years: 2013-2016

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Abstract

Objective: Prospective cohort studies regarding job strain and the risk of stroke are controversial. This meta-analysis aimed to evaluate the association between job strain and the risk of stroke.

Methods: The PubMed, Embase, and PsycINFO databases were searched for prospective cohort studies with data on job strain and the risk of stroke. Studies were included if they reported adjusted relative risks (RRs) with 95% confidence intervals (CIs) of stroke from job strain. Subgroup analyses were conducted according to sex and stroke type.

Results: Six prospective cohort studies comprising 138,782 participants were included. High strain jobs were associated with increased risk of stroke (RR 1.22, 95% CI 1.01–1.47) compared with low strain jobs. The result was more pronounced for ischemic stroke (RR 1.58, 95% CI 1.12–2.23). The risk of stroke was significant in women (RR 1.33, 95% CI 1.04–1.69) and nonsignificant in men (RR 1.26, 95% CI 0.69–2.27), but the difference in RRs in sex subgroups was not significant. Neither active (RR 1.07, 95% CI 0.90–1.28) nor passive (RR 1.01, 95% CI 0.86–1.18) job characteristics were associated with an increased risk of stroke compared with low strain jobs.

Conclusions: Exposure to high strain jobs was associated with an increased risk of stroke, especially in women. Further studies are needed to confirm whether interventions to reduce work stress decrease the risk of stroke.

Footnotes

  • ↵* These authors contributed equally to this work.

  • Received December 17, 2014.
  • Accepted in final form April 28, 2015.

Responses to this article

  • Stress and cardiovascular disease: could working better mean less stroke?
    • Simona Lattanzi and
    • Mauro Silvestrini, Ancona, Italy
    published online November 4, 2015
  • Job strain and risk of stroke: Is current research conclusive?
    • Renzo Bianchi
    published online October 23, 2015
  1. Published online before print October 14, 2015, doi: 10.1212/WNL.0000000000002098 Neurology 10.1212/WNL.0000000000002098
  1. » Abstract
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  3. Data Supplement
  4. Accompanying Editorial

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