‘Stress, impaired sleep pose higher death risk in workers with hypertension’

A research has linked work stress and impaired sleep to a threefold higher risk of cardiovascular death in employees with hypertension.

The finding was published in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).

Study author Professor Karl-Heinz Ladwig, of the German Research Centre for Environmental Health and the Medical Faculty, Technical University of Munich, said: “Sleep should be a time for recreation, unwinding, and restoring energy levels. If you have stress at work, sleep helps you recover. Unfortunately poor sleep and job stress often go hand in hand, and when combined with hypertension the effect is even more toxic.”

One-third of the working population has hypertension (high blood pressure). Previous research has shown that psychosocial factors have a stronger detrimental effect on individuals with pre-existing cardiovascular risks than on healthy people. This was the first study to examine the combined effects of work stress and impaired sleep on death from cardiovascular disease in hypertensive workers.

The study included 1,959 hypertensive workers aged 25-65, without cardiovascular disease or diabetes. Compared to those with no work stress and good sleep, people with both risk factors had a three times greater likelihood of death from cardiovascular disease. People with work stress alone had a 1.6-fold higher risk while those with only poor sleep had a 1.8-times higher risk.

During an average follow-up of nearly 18 years, the absolute risk of cardiovascular death in hypertensive staff increased in a stepwise fashion with each additional condition. Employees with both work stress and impaired sleep had an absolute risk of 7.13 per 1,000 person-years compared to 3.05 per 1,000-person years in those with no stress and healthy sleep. Absolute risks for only work stress or only poor sleep were 4.99 and 5.95 per 1,000 person-years, respectively.

In the study, work stress was defined as jobs with high demand and low control – for example when an employer wants results but denies authority to make decisions. “If you have high demands but also high control, in other words you can make decisions, this may even be positive for health,” said Professor Ladwig. “But being entrapped in a pressured situation that you have no power to change is harmful.”

Impaired sleep was defined as difficulties falling asleep and/or maintaining sleep. “Maintaining sleep is the most common problem in people with stressful jobs,” said Ladwig. “They wake up at 4 o’clock in the morning to go to the toilet and come back to bed ruminating about how to deal with work issues.”

“These are insidious problems,” noted Ladwig. “The risk is not having one tough day and no sleep. It is suffering from a stressful job and poor sleep over many years, which fade energy resources and may lead to an early grave.”

The findings are a red flag for doctors to ask patients with high blood pressure about sleep and job strain, said Ladwig. “Each condition is a risk factor on its own and there is cross-talk among them, meaning each one increases risk of the other. Physical activity, eating healthily and relaxation strategies are important, as well as blood pressure lowering medication if appropriate.”

Employers should provide stress management and sleep treatment in the workplace, he added, especially for staff with chronic conditions like hypertension.

Meanwhile, new report warns that nearly half of all jobs could be lost or radically transformed as a result of automation within the next two decades.

A recent employment outlook from the Organisation for Economic Co-operation and Development (OECD), a coalition consisting of 36 countries across the world, said that within the next two decades half of all jobs will be substantially transformed by technology.

In some cases, that will mean workers losing their jobs outright – the OECD estimates 14 percent of jobs will be completely automated in the next two decades – while others, 32 percent of jobs, will be vastly different from what they look like now.

Whether jobs are transformed or lost completely to the advance of technology, the OECD says one question rises above all others: “are we ready?”

“The OECD Employment Outlook does not envisage a jobless future. But it does foresee major challenges for the future of work,” said OECD Secretary-General Angel Gurría, in a statement.

While many jobs will be changed or eliminated, the OECD says that the shift won’t necessarily equate to less overall jobs for workers. With new and improved technology, also comes new and skilled jobs.

Automation may even create jobs in the short term, say some analysts.

The problem, says the organisation, is ensuring that current workers are equipped to transition into those jobs now and in the future.