Work Pressure + Authority = Heart Disease (for Women)?

May 28, 2004 ( - The combination of heavy work pressure and high authority may take a toll on some women's heart health, according to new research published in the American Journal of Epidemiology.

The study of more than 3,000 adults ages 18 to 77 found that over 10 years, women in demanding jobs with high levels of autonomy or authority had an increased risk of developing heart disease – three times as likely as women with high job demands and little autonomy, in fact. The same was not true of men, the researchers found, and highly demanding work in and of itself was not related to heart disease risk in either women or men, according to Reuters Health.

However, other features of work life – including authority over decision-making for women, and occupational “prestige” for men – did seem to make a difference in heart health.

While some studies have suggested high job strain may increase the risk of heart disease, a standard definition of that strain has been where workers deal with high demands but have little control over their work or leeway for creativity. In the current study, the presence of this type of high job strain was not related to the risk of heart disease or death in either men or women.

Ironically, this study found just the opposite trend among women under “active” job strain, which the researchers defined as having both high work demands and being in positions of authority, making decisions and controlling how they worked. The study suggests that work strain, when defined as high demand/low authority, is not a risk factor for heart disease for either men or women, lead author Dr. Elaine D. Eaker of Eaker Epidemiology Enterprises in Chili, Wisconsin, told Reuters Health.

For men in the study, higher income and higher job prestige were related to a lower risk of heart disease and death. But job strain, regardless of the level of authority, was not related to heart disease or death among men.

Exactly why “active” job strain might be a heart risk for women is unclear, the report authors say, but they speculate that societal factors are at work. This study, they point out, was begun in the 1980s, when women were first coming into high-power positions in significant numbers.

Noting that the women could be regarded as being on the “cutting edge of a social transition,” Eaker said the difficulty these women may have experienced in “breaking out of old roles and into roles with more authority” could have taken a toll on their health.