Women who report having high job strain have a 40 percent increased risk of cardiovascular disease, including myocardial infarctions and the need for revascularization procedures, compared to those with low job strain, according to research presented at the American Heart Association's Scientific Sessions 2010.

In addition, job insecurity - fear of losing one's job - was associated with risk factors for cardiovascular disease such as high blood pressure, increased cholesterol and excess body weight. However, it's not directly associated with heart attacks, stroke, invasive heart procedures or cardiovascular death, researchers said.

Job strain, a form of psychological stress, is defined as having a demanding job, but little to no decision-making authority or opportunities to use one's creative or individual skills.

"Our study indicates that there are both immediate and long-term clinically documented cardiovascular health effects of job strain in women," said Michelle A. Albert, M.D., M.P.H., the study's senior author and associate physician at Brigham and Women's Hospital, Boston, Mass. "Your job can positively and negatively affect health, making it important to pay attention to the stresses of your job as part of your total health package."

Researchers analyzed job strain in 17,415 healthy women who participated in the landmark Women's Health Study. The women were primarily Caucasian health professionals, average age 57 who provided information about heart disease risk factors, job strain and job insecurity. They were followed for more than 10 years to track the development of cardiovascular disease. Researchers used a standard questionnaire to evaluate job strain and job insecurity with statements such as: "My job requires working very fast." "My job requires working very hard." "I am free from competing demands that others make."

The 40 percent higher risks for women who reported high job strain included heart attacks, ischemic strokes, coronary artery bypass surgery or balloon angioplasty and death. The increased risk of heart attack was about 88 percent, while the risk of bypass surgery or invasive procedure was about 43 percent.

"Women in jobs characterized by high demands and low control, as well as jobs with high demands but a high sense of control are at higher risk for heart disease long term," said Natalie Slopen, Sc.D., lead researcher and a postdoctoral research fellow at Harvard University Center on the Developing Child in Boston.

Previous research on the effects of job strain has focused on men and had a more restricted set of cardiovascular conditions. "From a public health perspective, it's crucial for employers, potential patients, as well as government and hospitals entities to monitor perceived employee job strain and initiate programs to alleviate job strain and perhaps positively impact prevention of heart disease," Albert said.

Co-authors are Robert G. Glynn, Ph.D., and Julie Buring, Sc.D. Author disclosures are on the abstract.

The National Institutes of Health funded the Women's Health Study.