Effect of stress at work on the risk of cardiovascular diseases among the population of 25-64 years in Russia/Siberia (WHO program "MONICA-psychosocial")

The aim of the study was to determine the impact of stress on work on the risk of cardiovascular disease over a 16-year period in an open population of 25-64 years in Russia/Siberia. Materials and methods. A random representative sample of the population of both sexes of 25-64 years old in Novosibirsk in 1994 (men: n=657, 44.3 +/- 0.4 years, response - 82.1%, women: n=689, 45.4 +/- 0.4 years, response - 72.5%). The screening survey program included: registration of socio-demographic data, determination of stress at work (Karazek scale). The period of prospective follow-up of participants was 16 years. The study identified the following "end points": the first cases of myocardial infarction (MI), stroke. Results. A high level of stress at work was in 29.5% of men and 31.6% of women, the average level in 48.9% of men and 50.7% of women (chi(2)=2.574, 0=2, p=0.276). The risk of developing MI for a 16-year period, among people experiencing stressful situations at work, was: in men, HR=3.592, and women HR=3.218 (95% CI 1.146-9.042); stroke risk - among men, HR=2.603 (95% CI 1.06-4.153) in women HR=1.956 (95% CI 1.008-3.795). In multivariate analysis, in men with stress at work, the risk of MI among men was HR=1.15 (95% CI 0.6-2.2), among women - HR=2.543 (95% CI 1.88-7.351); risk of stroke, was in men, HR=3.8 (95% CI 1.6-8.8), in women - HR=1.95 (95% CI 0.984-3.887). The risk of stroke was higher among single, divorced and widowed men, HR=4.2 (95% CI 1.5-13.2), and in women with secondary or primary education, HR=3 (95% CI 0.852-11.039). Conclusion. It was established that a high level of stress at work is not gender-specific; the risk of developing MI over a 16-year period is higher in women than in men, stroke in men; the risk of myocardial infarction and stroke in both sexes is affected by the social gradient.