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. 2018 Jul;63(6):723-732.
doi: 10.1007/s00038-018-1118-2. Epub 2018 May 25.

Cardiovascular disease prevention at the workplace: assessing the prognostic value of lifestyle risk factors and job-related conditions

Giovanni Veronesi  1 , Rossana Borchini  2 , Paul Landsbergis  3 , Licia Iacoviello  4   5 , Francesco Gianfagna  4   5 , Patrick Tayoun  6 , Guido Grassi  7   8 , Giancarlo Cesana  9 , Marco Mario Ferrario  4   2 ; Cohorts Collaborative Study in Northern Italy (CCSNI) Research Group
Collaborators, Affiliations

Cardiovascular disease prevention at the workplace: assessing the prognostic value of lifestyle risk factors and job-related conditions

Giovanni Veronesi et al. Int J Public Health. 2018 Jul.

Abstract

Objectives: The prognostic utility of lifestyle risk factors and job-related conditions (LS&JRC) for cardiovascular disease (CVD) risk stratification remains to be clarified.

Methods: We investigated discrimination and clinical utility of LS&JRC among 2532 workers, 35-64 years old, CVD-free at the time of recruitment (1989-1996) in four prospective cohorts in Northern Italy, and followed up (median 14 years) until first major coronary event or ischemic stroke, fatal or non-fatal. From a Cox model including cigarette smoking, alcohol intake, occupational and sport physical activity and job strain, we estimated 10-year discrimination as the area under the ROC curve (AUC), and clinical utility as the Net Benefit.

Results: N = 162 events occurred during follow-up (10-year risk: 4.3%). The LS&JRC model showed the same discrimination (AUC = 0.753, 95% CI 0.700-0.780) as blood lipids, blood pressure, smoking and diabetes (AUC = 0.753), consistently across occupational classes. Among workers at low CVD risk (n = 1832, 91 CVD events), 687 were at increased LS&JRC risk; of these, 1 every 15 was a case, resulting in a positive Net Benefit (1.27; 95% CI 0.68-2.16).

Conclusions: LS&JRC are as accurate as clinical risk factors in identifying future cardiovascular events among working males. Our results support initiatives to improve total health at work as strategies to prevent cardiovascular disease.

Keywords: Cardiovascular prevention; Clinical utility; Discrimination; Global workers’ health; Job strain; Lifestyle; Risk estimation; Workplace.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

No written informed consent signed by participants was required at the time of recruitment.

References

    1. Arena R, Guazzi M, Briggs PD, Cahalin LP, Myers J, Kaminsky LA, et al. Promoting health and wellness in the workplace: a unique opportunity to establish primary and extended secondary cardiovascular risk reduction programs. Mayo Clin Proc. 2013;88(6):605–617. doi: 10.1016/j.mayocp.2013.03.002. - DOI - PMC - PubMed
    1. Baecke JA, Burema J, Frijters JE. A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr. 1982;36:936–942. doi: 10.1093/ajcn/36.5.936. - DOI - PubMed
    1. Buckley JP, Hedge A, Yates T, Copeland RJ, Loosemore M, Hamer M, et al. The sedentary office: an expert statement on the growing case for change towards better health and productivity. Br J Sports Med. 2015;49:1357–1362. doi: 10.1136/bjsports-2015-094618. - DOI - PubMed
    1. Cahalin LP, Myers J, Kaminsky L, Briggs P, Forman DE, Patel MJ, et al. Current trends in reducing cardiovascular risk factors in the United States: focus on worksite health and wellness. Prog Cardiovasc Dis. 2014;56(5):476–483. doi: 10.1016/j.pcad.2013.10.002. - DOI - PubMed
    1. Cesana GC, De Vito G, Ferrario M, Libretti A, Mancia G, Mocarelli P, et al. Ambulatory blood pressure normalcy: the PAMELA Study. J Hypertens Suppl. 1991;9:17–23. - PubMed

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