Atrial fibrillation (AF), the most common type of arrhythmia (irregular heartbeat), is estimated to cause 583 hospitalisations per 100,000 population in Canada. Non-modifiable risk factors (risk factors that cannot be controlled or changed) of AF include advancing age, family history, and genetics; modifiable risk factors of AF include alcohol consumption, high blood pressure, obesity, smoking, and stress. In a recent Canadian study published by Edwige Tiwa Diffo and colleagues in the Journal of the American Heart Association, psychosocial stressors at work were shown to markedly increase the chance of developing AF.
Psychosocial stressors at work can include many factors such as job strain, high effort, low reward, job insecurity, poor communication, and lack of support from managers or coworkers. In the study by Diffo and colleagues, 5,926 white-collar workers without cardiovascular disease were followed for approximately 18 years. The PROQ (Prospective Quebec Study on Work and Health) was initiated in the province of Quebec between 1991 and 1993 with follow-up completed in 2018; participants were linked with medical databases to identify AF events. Job strain and effort-reward imbalance (ERI) at work were assessed using validated instruments in the form of questionnaires; study results found that 19% of workers experienced job strain, while 25% experienced ERI. Further, job strain was associated with an 83% increased risk of developing AF, while ERI was associated with a 44% increased risk. Even more concerning is workers with combined exposure to job strain and ERI had a 97% increased risk of developing AF compared with unexposed workers. According to GlobalData epidemiologists, diagnosed prevalent cases of AF in ages 40 years and older are expected to grow from 527,000 cases in 2024 to 649,000 cases by 2032 in Canada. To address the increasing public health burden associated with AF, prevention and risk reduction are key.
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GlobalData epidemiologists expect that the results of this study may prompt individuals to consider implementing healthier lifestyles and more effective ways to manage stress. It may also help initiate workplace interventions targeted at reducing psychosocial stressors, including recognition of hard work or achievements, increased workplace support, and similar measures. GlobalData epidemiologists suggest that additional research be conducted to further support, elaborate on, and replicate these findings to enable the development of a targeted and actionable public health initiative.
