Adverse Effect of Psychosocial Stressors at Work and Long Working Hours Along the Cardiovascular Continuum

Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality worldwide. In 2019, CVDs caused an estimated 17.9 million deaths worldwide representing 32% of all global deaths. To improve both primary and secondary CVD prevention, strategies must tackle alterations across all phases of the cardiovascular continuum. This continuum is framed as a chain of events, initiated with risk factors, and progressing to subclinical organ damage, cardiovascular events, and recurrences up to end-stage organ disease and death. Most adults in OECD countries spend over half of their awake time at work, and about 20–25% of them are exposed to psychosocial stressors at work. Work is therefore a major life course component and a promising avenue for prevention. Evidence supports the adverse effect of psychosocial stressors at work and long working hours on cardiovascular manifestations, including high blood pressure, CVD incidence, and CVD recurrence. This chapter presents a synthesis of recent evidence on the adverse effects of these work stressors over the life course, at different stage of the cardiovascular continuum. Considering that important differences between women and men have been observed in these effects, sex and gender considerations will also be presented. The major underlying mechanisms and interactions with other risk factors will be summarized. Finally, the integration of the psychosocial working environment in the most recent guidelines for CVD prevention and in recent legislations will also be discussed. Future directions to improve prevention strategies will be highlighted along with current research priorities.