Working long hours may increase risk of second heart attack

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In a new study from The CHU de Québec-Université, researchers found that in patients who return to work after a heart attack, those who work more than 55 hours per week increase their odds of having a second heart attack by about twofold.

This is the first study of its kind to examine the effect of long working hours and the risk of a second cardiovascular event among patients who return to work after a first heart attack.

The study recruited 967 patients from 30 hospitals across Quebec, Canada, between 1995 and 1997.

Patients had a history of heart attack, were younger than 60 years of age, held a paying job within the year prior to their heart attack and planned to return to work.

Based on their total weekly working hours, the people were placed into four categories: 1) part-time (21-34 hours/week), 2) full-time (35-40 hours/week), 3) low overtime (41-54 hours/week) and 4) medium/high overtime (>55 hours/week).

The researchers measured levels of stressful work through job strain.

If a participant had high psychological demands at work (quantity of work, time constraints and level of intellectual effort required) and low decision control (opportunities for learning, autonomy and participation in the decision-making process), they were classified as having job strain. In addition, social support in and out of work was measured.

The team found during the study period, 21.5% of participants had a second heart attack. Working long hours was associated with an about a twofold increase in the risk of a second heart attack.

Men were more likely to be working medium/high overtime hours (10.7% of men vs. 1.9% of women), as well as younger workers.

In addition, those with worse lifestyle risk factors (smoking, alcohol intake, physical inactivity), and who worked a more stressful job were also more likely to be in the medium/high overtime category.

The team says long working hours should be assessed as part of early and subsequent routine clinical follow-up to improve the prognosis of post-heart attack patients.

The study results have important implications for clinical practice, such as more comprehensive measures for secondary prevention for heart attack patients.

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The study is published in the Journal of the American College of Cardiology. One author of the study is Xavier Trudel, Ph.D.

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