The relation of psychosocial dimensions of work with coronary heart disease risk factors: a meta-analysis of five United States data bases

Abstract

The relation of job psychologic demands and decision latitude to four coronary heart disease risk factors (cholesterol, smoking, and systolic and diastolic blood pressures) was tested among 12,555 men in five investigations conducted in the United States during the period 1959-1980 (National Health and Nutrition Examination Surveys I and II, National Health Examination Survey, Western Collaborative Group Study, and Exercise Heart Survey). Using an imputation strategy, the authors attached measures of the two job characteristics above to persons in each data base by occupation. In 19 possible tests, decision latitude was related (p less than 0.05) to cholesterol and smoking in two instances in the predicted direction in the Exercise Heart Survey, when controlling for Type I error rate. Psychologic demands were not related to any of the risk factors. When a meta-analysis was performed across data bases, all relations were in the predicted direction except for the relation of psychologic demands to systolic pressure, and two of these were statistically significant (p less than 0.05): the relation of job decision latitude to smoking and to systolic pressure. The interaction of psychologic demands and decision latitude was not related to any of the risk factors when two common forms of an interaction were tested. These results indicate that psychosocial aspects of work, in particular the decision latitude of the job, may be related to some cardiovascular risk factors.