Heart of the matter: Work stress may lead to atrial fibrillation

Work-related stress caused by job strain and an imbalance between efforts applied versus rewards received may increase the risk of developing atrial fibrillation, according to new research published in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association (AHA).

Also known as AFib or AF, atrial fibrillation is the most common form of arrhythmia – an abnormal heart rhythm.  It can lead to stroke, heart failure or other cardiovascular complications. More than 12 million people are projected to have AFib in the United States by 2030, according to the American Heart Association’s 2024 heart disease and stroke statistics.

Previous research linked high job strain and effort-reward imbalance at work with an increased risk of coronary heart disease. This research is the first to examine the adverse effect of both psychosocial stressors at work on atrial fibrillation, said the study’s senior author, Xavier Trudel, Ph.D., an occupational and cardiovascular epidemiologist and associate professor at Laval University in Quebec City, Quebec, Canada.

“Our study suggests that work-related stressors may be relevant factors to include in preventive strategies,” Trudel said. “Recognizing and addressing psychosocial stressors at work are required to foster healthy work environments that benefit both individuals and the organizations where they work.”

Trudel and his team studied the effect of job strain – which refers to a work environment in which employees face high job demands, such as a heavy workload and tight deadlines, and low control over their work with little say in decision-making and how they execute their tasks.

Another factor assessed in the study was the effort-reward imbalance. This occurs when employees invest significant effort into their work but perceive the rewards they get in return – such as salary, recognition or job security – as insufficient or unequal to their performance.

In the study, researchers examined medical database records for nearly 6,000 adults in white-collar jobs, with 18 years of follow-up data. The analysis found that:

• employees who said they experienced high job strain had an 83% higher risk of developing AFib compared to workers unaffected by the stressors;
• those who perceived an effort-reward imbalance had a 44% greater risk, compared to workers who did not report this imbalance; and
• combined perceptions of high job strain and effort-reward imbalance were associated with a 97% increased risk of AFib.

“The effectiveness of workplace interventions to reduce psychosocial stressors that may also reduce the risk of AFib should be investigated in future research efforts,” Trudel said. “Our research team previously conducted an organizational intervention designed to reduce psychosocial stressors at work, which was shown to effectively reduce blood pressure levels. Examples of organizational changes implemented during the intervention included slowing down the implementation of a large project to prevent increased workload; implementing flexible work hours; and holding meetings between managers and employees to discuss day-to-day challenges.”

Limitations of the study included that participants were all white-collar workers in Canada, which means results may not apply to other types of workers or to workers in other countries.