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For the purposes of research, stress at work has two components—high workload and low autonomy. Jobs with both characteristics are unhealthy, especially for people with coronary heart disease. In one Canadian study, chronic job strain doubled the risk of recurrent heart disease in 972 adults (mostly men) returning to work after a heart attack (hazard ratio 2.00, 95% CI 1.08 to 3.72)3.72).
The researchers measured participant's job strain soon after their return to work and again two years later. People who scored highly on both occasions were significantly more likely to die of coronary heart disease, have another non-fatal heart attack, or develop unstable angina than those with less stressful jobs, over a follow-up of six years. The association persisted after adjusting for more than two dozen potentially confounding factors. Job strain seems to be an independent predictor of outcome for middle aged men with a history of heart attack.
While these findings are biologically plausible and consistent with research on other psychosocial stresses, the picture may be different for women, says a linked editorial (p 1693). There were only 106 women in this study (11%), so the researchers weren't able to analyse the sexes separately.