Chronic stress at work and the metabolic syndrome: prospective study

Objectives: Stress at work has been linked with coronary heart disease but the biological mechanisms remain unclear. The metabolic syndrome is a candidate mediating factor but there are no prospective studies of this association. Design: Work stressors, based on the Iso-strain model, were measured on four occasions (1985-1999). Biological measures constituting the metabolic syndrome were measured in 1999. Setting: Prospective cohort study of London-based civil servants followed up for an average of 15 years (the Whitehall II study) Participants: White collar men and women, aged 35-55, and employed in 20 civil service departments at baseline. Main outcome measures: The metabolic syndrome (NCEP definition) Results: There was a dose-response relationship between exposure to work stressors over 15 years and risk of the metabolic syndrome, independent of other risk factors for the syndrome. Employees with chronic work stress (3 or more exposures) had over twice the odds of the syndrome compared to those reporting no exposure to work stress (age and employment grade adjusted OR = 2.25, 95% CI 1.31, 3.85). Conclusions: Stress at work is an important risk factor for the metabolic syndrome. The study provides evidence for the biological plausibility of the link between psychosocial stressors from everyday life and heart disease