Job stress and coronary heart disease: a case-control study using a Chinese population

J Occup Health. 2009;51(2):107-13. doi: 10.1539/joh.l8060. Epub 2009 Jan 30.


Objectives: This study was to examine the association between job stress and coronary heart disease (CHD) in a Chinese population.

Methods: The 388 participants aged 30 to 70 yr who received coronary angiography for suspected or known ischemic heart disease were enrolled in this series, which included 292 CHD cases and 96 controls. The job stress before CHD onset was measured by the effort-reward imbalance (ERI) model.

Results: In the results, compared with the baseline, high ERI, high extrinsic effort or high overcommitment increased the risk of CHD with odds ratios (OR) of 2.8, 2.7 and 2.8 respectively after adjustment for the traditional CHD risk factors, such as age, gender, primary hypertension, diabetes mellitus, hyperlipidemia, smoking, body mass index, CHD family history, educational level, and marital status. The combination of high ERI and high overcommitment led to the highest risk of CHD with adjusted OR 5.5. However, high reward reduced the risk of CHD with an adjusted OR of 0.4 in comparison to low reward. Dose-response relationships were also observed.

Conclusions: Job stress evaluated by the ERI model significantly increased the risk of CHD, and it may be an important risk factor independent of the traditional risk factors of CHD in the Chinese population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • China
  • Coronary Angiography
  • Coronary Disease / diagnosis
  • Coronary Disease / etiology*
  • Coronary Disease / psychology
  • Female
  • Humans
  • Internal-External Control
  • Male
  • Middle Aged
  • Myocardial Ischemia / diagnosis
  • Myocardial Ischemia / etiology
  • Myocardial Ischemia / psychology
  • Occupational Diseases / diagnosis
  • Occupational Diseases / etiology*
  • Occupational Diseases / psychology
  • Risk Factors
  • Stress, Psychological / complications*