According to a recent survey, civil servants may be facing an increased heart attack risk due to stress at work.
The study, which is a part of the long-running Whitehall II study that has been following 10,308 London-based civil servants since 1985, led by Sir Michael Marmot, professor of epidemiology and public health at University College London, UK provided strong evidence linked to the biological mechanisms involved in the onset of heart disease.
Dr Tarani Chandola, the first author of this EHJ study and a senior lecturer in UCL's Department of Epidemiology and Public Health said that though work stress leads to risk of coronary heart disease but the mechanisms are still not clear.
"This study addressed three questions: 1) Is the accumulation of work stress associated with higher risks of incident CHD and risk factors" 2) Is this association stronger among working-age populations" 3) Does work stress affect CHD directly through neuroendocrine mechanisms, or indirectly through behavioural risk factors for CHD, or both"" said Dr Chandola.
Over a 12 year period, the team gathered data related to the incidence of CHD, deaths from CHD, non-fatal myocardial infarctions, angina, heart rate variability, morning rises in the levels of the "stress" hormone cortisol, the metabolic syndrome  and behavioural risk factors such as diet, exercise, smoking and drinking.
The findings revealed that chronic work stress associated with CHD was greater among men and women aged under 50
"During 12 years of follow-up, we found that chronic work stress was associated with CHD and this association was stronger among both men and women aged under 50 - their risk of CHD was an average of 68% more than for people who reported no stress at work. Among people of retirement age (and therefore less likely to be exposed to work stress), the effect on CHD was less strong," he said.
The most imperative finding was the link between work stress with the biological mechanisms harbouring CHD. They found that workers who suffered from greater stress were more likely to have lowered heart rate variability.
Work stress also lead to poor health behaviours that could lead indirectly to CHD.
"Work stress is associated with a poorer diet in terms of eating less fruit and vegetables, and less exercise. It has also been linked to problem drinking, although not in this study. In this study, around 32% of the effect of work stress on CHD could be explained by its effect on health behaviours and the metabolic syndrome," he said.
Dr Chandola said that cumulative stress at work can lead to CHD through direct activation of neuroendocrine stress pathways and indirectly through unhealthy behaviours.
The findings appear in Europe's leading cardiology journal, the European Heart Journal.