Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men.

TLDR

The study examined how specific job characteristics influence subsequent cardiovascular disease in a large random sample of Swedish men. Using multivariate logistic regression and a case‑controlled design, the authors prospectively analyzed coronary heart disease symptoms, signs, and deaths over six years. Hectic, psychologically demanding jobs and low decision latitude—particularly low intellectual discretion and limited personal schedule freedom—were associated with higher risk of CHD symptoms, signs, and premature CHD‑CVD death, with odds ratios ranging from 1.29 to 6.6, even after adjusting for age, education, smoking, and overweight.

Abstract

The association between specific job characteristics and subsequent cardiovascular disease was tested using a large random sample of the male working Swedish population. The prospective development of coronary heart disease (CHD) symptoms and signs was analyzed using a multivariate logistic regression technique. Additionally, a case-controlled study was used to analyze all cardiovascular-cerebrovascular (CHD-CVD) deaths during a six-year follow-up. The indicator of CHD symptoms and signs was validated in a six-year prospective study of CHD deaths (standardized mortality ratio 5.0; p less than or equal to .001). A hectic and psychologically demanding job increases the risk of developing CHD symptoms and signs (standardized odds ratio 1.29, p less than 0.25) and premature CHD-CVD death (relative risk 4.0, p less than .01). Low decision latitude-expressed as low intellectual discretion and low personal schedule freedom-is also associated with increased risk of cardiovascular disease. Low intellectual discretion predicts the development of CHD symptoms and signs (SOR 1.44, p less than .01), while low personal schedule freedom among the majority of workers with the minimum statutory education increases the risk of CHD-CVD death (RR 6.6, p less than .0002). The associations exist after controlling for age, education, smoking, and overweight.