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Health
Stress
and heart problems
Wendy
Moore
Experts
in medicine and stress have argued for decades over whether
stress can cause problems with the heart and cardiovascular
system, including strokes and raised blood pressure. The
facts are still unclear but growing evidence does support
a link between certain kinds of stress and problems with
the heart.
Links
between stress and heart problems
The Government's health white paper, Saving Lives, published
in 1999, warns that people in stressful jobs - with either
very high demands or little control over their work - are
more likely to suffer heart disease. It cites a long-running
study of civil servants, the Whitehall II study, which shows
that women in high demand/low control jobs are more than
70% more likely to develop coronary heart disease than their
counterparts in jobs with high levels of control. Men in
low control jobs are more than 50% more likely to develop
heart problems than men in high control jobs.
The
British Heart Foundation believes that while the impact
of stress on the heart disease is still uncertain, stress
does seem to play a role in increasing risk. It points to
research which shows that people under work strain, suffering
depression or with an 'angry' personality, are more likely
to develop heart problems. The charity warns that for people
who already have heart disease, stress can bring on angina
or even - very exceptionally - a heart attack.
The
American Heart Association agrees. It says: 'More and more
evidence suggests a relationship between the risk of cardiovascular
disease and environmental and psychosocial factors.'
Heart
attacks
Some studies have even found that stress can cause fatal
heart attacks. One study, published in the British Medical
Journal in 2000, reported that more men died of heart attacks
on the day the Dutch football team was eliminated from the
European football championship in 1996 than on an average
day. Another study, published in the British Medical Journal
in 1998, found that men working very long hours in Japan
- more than 11 hours a day - are more prone to fatal heart
attacks. However, it also found men working less than seven
hours a day are more at risk than those working seven to
nine hours a day.
A new
book out this year, Stress and The Heart, brings together
experts in the field to analyse all the research. This cites
studies which show clear links between heart problems and
certain kinds of work stress, depression, anxiety and hostility.
But
not everybody is convinced. Graham MacGregor, professor
in cardiovascular medicine at St George's Hospital, London,
dismisses the research as flawed. He says: 'There is no
evidence that stress leads to high blood pressure or to
heart disease. Professor MacGregor, who chairs the Blood
Pressure Association, accepts that stress may trigger a
heart attack in people already suffering severe heart disease.
But he does not believe research so far has conclusively
proved a link between stress and developing heart problems.
Work
strain and heart problems
The possibility of a link between a stressful job and heart
problems was first suggested nearly 100 years ago. As heart
disease became a growing problem in the west, it first increased
among people in better-off social classes. This led to the
idea of 'executive stress' causing heart attacks. But as
heart disease began to decline in the 1970s it has fallen
fastest among the better-off so that people in lower income
groups are now more at risk. It is now believed that the
stress involved in a job lower down the pecking order is
more likely to cause heart problems.
Since
the 1960s a number of studies have linked two types of work
strain to increased heart disease. One group of studies
has found that people in jobs with high demands and low
control are more prone to heart problems. The other branch
of research has found that people in jobs with high effort
for little reward suffer more heart disease.
An analysis
of several studies, reported in the book Stress and The
Heart, has found that people in high effort/low reward jobs
are between two and six times more likely to develop coronary
heart disease. An overview of research on job control found
links between high demands/low control and heart disease
in 17 out of 25 studies. As well as the Whitehall II study
of civil servants, which established the link, the phenomenon
has been spotted in major studies in Germany, Sweden and
Finland. The Whitehall II study found that both kinds of
work stress were independently related to heart problems.
People suffering both kinds of strain doubled their heart
disease risk, compared to those under one type of stress,
the research found.
'There
is no doubt that people who occupy jobs which are repetitive,
where they have little control over what they are doing,
do have a higher risk of heart disease,' says Dr Eric Brunner,
senior lecturer in epidemiology at University College London,
who is one of the contributors to Stress and The Heart.
Source:
www.heartdisease.about.com
Copyright
(R) thedailystar.net 2004
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