A new study shows a link between work stress and trouble sleeping with a threefold higher risk of cardiovascular death in employees with hypertension.
“Sleep should be a time for recreation, unwinding, and restoring energy levels,” said Professor Karl-Heinz Ladwig of the German Research Centre for Environmental Health and the Medical Faculty, Technical University of Munich. “If you have stress at work, sleep helps you recover. Unfortunately poor sleep and job stress often go hand in hand, and when combined with hypertension the effect is even more toxic.”
One-third of the working population has hypertension, also known as high blood pressure, the researcher noted. Previous studies have shown that psychosocial factors have a stronger detrimental effect on individuals with pre-existing cardiovascular risks than on healthy people.
The new study included 1,959 hypertensive workers between the ages of 25 and 65 who did not have cardiovascular disease or diabetes. Compared to those with no work stress and good sleep, people with both risk factors had a three times greater likelihood of death from cardiovascular disease, according to the study’s findings.
People with work stress alone had a 1.6-fold higher risk, while those with only poor sleep had a 1.8 times higher risk, according to the researcher.
During an average follow-up of nearly 18 years, the risk of cardiovascular death in hypertensive employees increased in a stepwise fashion with each additional condition, the study discovered.
Employees with both work stress and impaired sleep had an absolute risk of 7.13 per 1,000 person-years compared to 3.05 per 1,000-person years in those with no stress and healthy sleep. Absolute risk for only work stress was 4.99, while it was 5.95 for poor sleep.
In the study, work stress was defined as jobs with high demand and low control, for example when an employer wants results but denies authority to make decisions.
“If you have high demands but also high control — in other words you can make decisions — this may even be positive for health,” said Ladwig. “But being entrapped in a pressured situation that you have no power to change is harmful.”
Impaired sleep was defined as difficulties falling asleep and/or maintaining sleep. “Maintaining sleep is the most common problem in people with stressful jobs,” he said. “They wake up at 4 o’clock in the morning to go to the toilet and come back to bed ruminating about how to deal with work issues.”
“These are insidious problems,” he continued. “The risk is not having one tough day and no sleep. It is suffering from a stressful job and poor sleep over many years, which [deplete] energy resources and may lead to an early grave.”
Based on these finding, doctors should ask patients with high blood pressure about sleep and job stress, Ladwig said.
“Each condition is a risk factor on its own and there is cross-talk among them, meaning each one increases (the) risk of the other,” he said. “Physical activity, eating healthily, and relaxation strategies are important, as well as blood pressure-lowering medication if appropriate.”
Employers should provide stress management and sleep treatment in the workplace, he added, especially for staff with chronic conditions like hypertension.
The study was published in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology.
Source: European Society of Cardiology