Medical Perspectives | Cardio-Metabolic

July 30, 2021

Jian Li et. al.

Stress in the workplace is a serious problem that can contribute towards heart disease. With most adults spending around half of their waking hours at work, the workplace is an important setting to promote health and well-being.

Increasingly, attentionbeing paid to the psychosocial work environment, with a major focus on work stress.

Six steps theoretical model by Jian Li

  • Step 1: Work Stress Increases the Risk of Incident Cardiovascular Disease  in Healthy Workers
    • Job-Control-Demand model (Karasek) and Effort-Reward Imbalance model (Siegrist), revealed that there is a 10%-40% comparison between excess CVD risks for those exposed to work stress than those workers without work stress.
  • Step 2: Work Stress Determines the Process of Return to Work after CVD Onset
    • Medical factors, demographic distribution and psychiatric conditions were determinants in the process of returning to work of people who had CVD onset. Psychosocial stress in the workplace was also given a highlight together with another major risk factor of no return to work which is, high-level of work stress and low level of job satisfaction.
  • Step 3: Patients with CVD Experience Higher Work Stress after Return to Work
    • Work stress level increased after the workers with CVD returned to work. This is mostly due to reduced health-related work performance, thus limiting their capacity to cope with their previous workload prior CVD onset. Their functional impairment leads to fewer opportunities of promotion and financial progress hence a reduced autonomy.
  • Step 4: Work Stress Increases the Risk of Recurrent CVD in Workers with CVD
    • There is still lack of information to further prove that there are bigger risks of having recurrent CVD after the 1st episode in patients or workers affected.
  • Step 5: Patients with CVD Who Suffer Full and Permanent Loss of Work Ability Transit to Disability Retirement
    • Severe CVD may result in complete loss of work ability thus forcing the affected person to retirement.
  • Step 6: Disability Retirees due to CVD are at Increased Risk of CVD Mortality
    • Psychosocial stress such as loss of status, feeling of worthlessness, worsening economic burden, and social isolation are considered to play an essential role in the increase in mortality in individuals with disability retirement.


Work stress affects the individual in more than one aspect, and how it is greatly linked with CVD. Most individuals spend one-third of their lives in the workplace, wherein work stress generally yields.  A wide range of strategies to reduce stress may be done to lessen risk of CVD among workers. Modification of workload and environment may improve quality of life of the affected individuals.


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