When family demands affect work performance or work demands undermine family obligations, the resulting stress may contribute to decreased heart health, particularly among women, a new study finds.
The study, published Thursday in the Journal of the American Heart Association, adds another factor for doctors and patients to evaluate in treating cardiovascular problems, said the study's senior author, Dr. Itamar Santos, a professor at the University of São Paulo and a researcher in the Brazilian Longitudinal Study of Adult Health.
"There are very consistent results showing that people under higher stress have more cardiovascular disease," he said. "We wanted to specifically study the effect of work-family conflict."
Santos and his colleagues studied more than 11,000 workers in Brazil between ages 35 and 74. The workers filled out questionnaires based on a model that measures the impact of work on family life, and vice versa.
Their heart health was scored using questionnaires, clinical exams and laboratory results for health metrics, including smoking, body mass index, diet, physical activity, cholesterol, blood pressure and blood sugar level.
The study found lower cardiovascular health scores most evident in women who reported a variety of frequent work-family conflicts.
Experts warn chronic stress can affect the heart by increasing inflammation in the body. That can affect blood pressure and cholesterol, as well as lead to unhealthy lifestyle behaviors such as lack of sleep and exercise, poor diet and weight gain.
Dr. Gina Price Lundberg, a preventive cardiologist in Atlanta and clinical director of the Emory Women's Heart Center, said the study reinforces the need for a healthy work-life balance.
"It's a really good, well-designed study with large numbers, a good balance of men and women and lots of diversity," said Lundberg, who wasn't involved in the research. "I think this shows what we already felt was valid – that work-life integration is hard.
"When you work a lot, you don't have time for leisure or healthy habits. You don't find time to get to the gym or just have a good night's sleep."
Although both genders were affected, Santos said, the impact on women was greater.
"This was interesting because in our previous study, job stress alone affected men and women almost equally," he said. "But we found that for work-family conflict, women are more affected than men. They seem to be especially susceptible to this kind of stress."
He suggested the disparity might be explained, at least for some women, by the importance they place on family life.
Lundberg agreed. "You feel the stress to fulfill the gender roles, and I think women still feel more of a need to have that nurturing home life," she said. "Men are helping more than ever, but I think working women still feel the stress of trying to do it all."
The Brazilian researchers plan to follow the study subjects for up to a decade.
"We want to see how these metrics of stress are associated with change in cardiovascular health over a long period, and to see how some people with the same levels of stress may have other characteristics that protect them from cardiovascular disease," Santos said.
In the meantime, he hopes the initial findings will help persuade workplaces to look for ways to reduce stress on the job, and encourage doctors to put more emphasis on recognizing stress as a component of health.
"We're not going to eliminate stress," Santos said. "But we should learn how to live with it to not have so many bad consequences."
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