Covert coping with unfair treatment at work and risk of incident myocardial infarction and cardiac death among men: Prospective cohort study
- Constanze Leineweber1,*,
- Hugo Westerlund1,
- Töres Theorell1,
- Mika Kivimäki2,
- Peter Westerholm3,
- Lars Alfredsson4
- 1 Stockholm University, Sweden;
- 2 University College London, United Kingdom;
- 3 Uppsala University, Sweden;
- 4 Karolinska Institute, Sweden
- Correspondence to: Constanze Leineweber, Stress Research Institute, Stockholm University, Stress Research Institute, Stockholm University, Stockholm, 10691, Sweden;
- Received 19 February 2009
- Accepted 2 September 2009
- Published Online First 24 November 2009
Objective: Covert coping with unfair treatment at work - occurring when an employee does not show the 'aggressor' that he/she feels unfairly treated - has been found to be associated with cardiovascular risk factors. We examine whether covert coping also predicts incident coronary heart disease.
Design:Prospective cohort study (the WOLF Stockholm study).
Settings: Workplaces in the Stockholm area, Sweden.
Participants: 2,755 men with no history of myocardial infarction at baseline screening in 1992-1995.
Main outcome measure: Hospitalisation due to myocardial infarction or death from ischemic heart disease until 2003 obtained from national registers (mean follow-up 9.8 ± 0.9 years).
Results: 47 participants had myocardial infarction or died from ischemic heart disease during the follow-up. After adjustment for age, socio-economic factors, risk behaviours, job strain and biological risk factors at baseline, there was a dose-response relationship between covert coping and risk of incident myocardial infarction or cardiac death (p for trend = 0.10). Men who frequently used covert coping had a 2.29 (95 % CI: 1.00 to 5.29) times higher risk than those who did no use this coping. Restricting the analysis to direct coping behaviours only strengthened this association (p for trend = 0.02).
Conclusions: In this study, covert coping is strongly related to increased risk of hard-end-point cardiovascular disease.