Associations between the effort-reward imbalance model of workplace stress and indices of cardiovascular health: A systematic review and meta-analysis


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Abstract

HighlightsERI and OC were most associated with IMT and fibrinogen.Sex moderates the association between OC and both IMT and mean BP.OC moderates the association between ERI and fibrinogen.‘White coat effect’ may explain disparity in ERI and hypertension associations.Work stress can increase the risk of cardiovascular disease by 50%, with increasing research focusing on the underlying mechanisms responsible for these associations. Our meta-analysis assessed the associations of the effort-reward imbalance (ERI) workplace stress model with indices of cardiovascular disease. The search term ‘effort*reward*imbalance’ produced 22 papers (129 associations, N = 93,817) meeting inclusion criteria. Greater ERI was most associated with increased hypertension (r = 0.26, p < 0.001, N = 1180), intima media thickness (r = 0.23, p < .001, N = 828) and fibrinogen (r = 0.13, p = 0.03, N = 4315). Trait over-commitment was most associated with increased hypertension (r = 0.24, p =0.02, N = 899) and intima media thickness (r = 0.19, p = 0.02, N = 828). Interventions aimed at reducing the impact of ERI and over-commitment on cardiovascular disease should consider concurrently assessing changes in physiological markers of cardiovascular disease.

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