journal · Public research summary
Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data
High demands combined with low job control were associated with incident coronary heart disease.
Educational only. Associations do not establish individual risk or diagnosis. Read the original sources and limitations. Editorial review: 2026-10-06.
Citation
Kivimäki et al. · The Lancet · 2012 · DOI: 10.1016/S0140-6736(12)60994-5
Study design
Evidence synthesis
Population
197,473 employed adults without coronary disease at baseline, from 13 cohorts.
Geography
Europe
Finding
High demands combined with low job control were associated with incident coronary heart disease.
Estimate
Job strain vs no job strain: age- and sex-adjusted hazard ratio 1.23 (95% CI 1.10–1.37); mean follow-up 7.5 years.
Measured relationship
Job strain → coronary events. The study does not establish blood pressure as the mediator or extend to every form of stress.
Limitations
Observational; publication and reverse-causation biases were examined but not eliminated. Employed European adults are not representative of all work or social settings.