People who go back to a stressful job after a heart attack are more prone to a second attack than those whose work is not stressful - a study says.
Not having control over your workload is what counts
Canadian researchers followed some 1,000 patients returning to work.
In six years, over 200 suffered heart problems again. Those with job strain were twice as likely to fall ill.
The Journal of the American Medical Association study defined job strain as having a high pressure workload but few decision-making powers.
Studies have also shown a link between job strain and a first heart attack, but researchers at Laval University in Quebec said little was known about the association with subsequent heart problems.
They said their findings on Canadian patients held up even after other risk factors had been accounted for, including lifestyle, socio-economic group and clinical prognosis.
Although further studies were still required, "information about the results of this study should be disseminated in cardiac practice and in occupational health services with the aim of reducing job strain for workers returning to work after a heart attack," the authors wrote.
June Davison, a cardiac nurse at the British Heart Foundation, said: "It is well known that people are more likely to feel stressed when they have little control over their work situation but have a lot of demands placed on them.
"We still need to further our understanding about how stress affects our heart and circulation. In the mean time, we can all help ourselves by recognising what stresses us and learning how to cope with stressful situations."