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Job strain and symptoms of angina pectoris among British and Finnish middle-aged employees
  1. T Lallukka1,
  2. T Chandola2,
  3. H Hemingway2,
  4. M Marmot2,
  5. E Lahelma1,
  6. O Rahkonen1
  1. 1
    Department of Public Health, University of Helsinki, Finland
  2. 2
    Department of Epidemiology & Public Health, University College London, UK
  1. Correspondence to Dr T Lallukka, Department of Public Health, P.O. Box 41 (Mannerheimintie 172), 00014 University of Helsinki, Finland; tea.lallukka{at}


Background: High job strain has been linked with cardiovascular outcomes. This study aimed to examine whether job strain is associated with angina pectoris symptoms among British and Finnish non-manual employees.

Methods: Postal questionnaire survey data among 40–60-year-old employees of the British Whitehall II Study (n = 4551, 27% women) and the Finnish Helsinki Health Study (n = 7605, 83% women) cohort were analysed. Angina pectoris symptoms were the outcome in logistic regression analysis. Karasek’s job strain was examined. Models were adjusted first for age, second for occupational class and finally for smoking, heavy drinking, physical inactivity, unhealthy food habits and obesity.

Results: Angina pectoris symptoms were reported by 5% of women and 3% of men in Britain, and by 6% of women and 4% of men in Finland. High job strain was associated with angina pectoris symptoms among men in Britain (OR 2.08; CI 95% 1.07 to 4.02) and women in Finland (OR 1.90; CI 95% 1.36 to 2.63) independent of age, occupational class, and behavioural risk factors. However, similar associations between job strain and angina pectoris symptoms were not observed among men in Finland or women in Britain.

Conclusion: The results yielded partial support for the association between job strain and angina pectoris symptoms across national contexts.

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  • Funding The Helsinki Health Study is supported by Academy of Finland (#205588, (#70631, #48600, #210435) and the Finnish Work Environment Fund. The Whitehall II study has been supported by grants from the Medical Research Council; British Heart Foundation; Health and Safety Executive; Department of Health; National Heart Lung and Blood Institute (HL36310), US, NIH: National Institute on Aging (AG13196), US, NIH; Agency for Health Care Policy Research (HS06516); and the John D and Catherine T MacArthur Foundation Research Networks on Successful Midlife Development and Socio-economic Status and Health. MM is supported by an MRC Research Professorship.

  • Competing interests None declared.

  • Ethics approval The University College London ethics committee approved the Whitehall II study, and the Helsinki Health Study has had ethical approval from the Department of Public Health, University of Helsinki as well as the city of Helsinki.

  • Provenance and Peer review Not commissioned; externally peer reviewed.