ArticleJournal of the American Heart Association2019
Occupational Class and Risk of Cardiovascular Disease Incidence in Japan: Nationwide, Multicenter, Hospital-Based Case-Control Study.
Article in Journal of the American Heart Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
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Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Psychosocial stress and risk of first-ever stroke: a systematic review and meta-analysis.BMC neurology · 2026Pooled it
- Stroke, Small-Vessel Disease, and Occupation: Systematic Review and Data Analysis.Journal of the American Heart Association · 2026Pooled it
- A case control study of occupation and cardiovascular disease risk in Japanese men and women.Scientific reports · 2021Trial
- Six anthropometric indicators and their associations with myocardial infarction and death in Swedish automotive industry male workers followed for 28 years.BMC public health · 2026Article
- Risk of Cardiovascular Disease According to Standard Industrial Sectors: A Nationwide Longitudinal Study.Journal of Korean medical science · 2026Article
- Lifestyle Factors and Thromboembolic Risk in Atrial Fibrillation: Age-Dependent Effects of Smoking and Alcohol Consumption.Journal of arrhythmia · 2026Article
- Association between job insecurity and cardiovascular diseases in workers with type 2 diabetes mellitus.Scandinavian journal of work, environment & health · 2026Article
- Article
- Association among occupational class, alcohol consumption, and the risk of hospitalisations due to alcoholic liver diseases: a matched case-control study.BMC public health · 2025Article
- Socioeconomic Status and Stroke: A Review of the Latest Evidence on Inequalities and Their Drivers.Stroke · 2025Review
- Comparison of 10-year atherosclerotic cardiovascular disease (ASCVD) risk in metropolitan and rural areas of South of Iran.Scientific reports · 2025Article
- Statistical Analysis of the Factors that Affect Postoperative Length of Hospital Stay after Unruptured Intracranial Aneurysm Treatment in Japan: A 20-year Nationwide Multicenter Study.Neurologia medico-chirurgica · 2024Article
- Incidence of coronary heart disease among remote workers: a nationwide web-based cohort study.Scientific reports · 2024Article
- Article
- Prevalence of coronary heart disease and its risk factors by working environment among Japanese male workers.Industrial health · 2023Article
- Article
- Length of employment in workplaces handling hazardous chemicals and risk of cancer among Japanese men.Occupational and environmental medicine · 2023Article
- Impact of Perceived Social Support on the Association Between Anger Expression and the Risk of Stroke: The Circulatory Risk in Communities Study (CIRCS).Journal of epidemiology · 2023Article
- An Index to Assess Overwork-Related Adverse Effects on Employees Under the Occupational Safety and Health Act in Taiwan.Safety and health at work · 2022Article
- Spatial-temporal analysis of cerebral infarction mortality in Hokkaido, Japan: an ecological study using a conditional autoregressive model.International journal of health geographics · 2022Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background In contemporary Western settings, higher occupational class is associated with lower risk for cardiovascular disease ( CVD ) incidence, including coronary heart disease ( CHD ) and stroke. However, in non-Western settings (including Japan), the occupational class gradient for cardiovascular disease risk has not been characterized. Methods and Results Using a nationwide, multicenter hospital inpatient data set (1984-2016) in Japan, we conducted a matched hospital case-control study with ≈1.1 million study subjects. Based on a standard national classification, we coded patients according to their longest-held occupational class (blue-collar, service, professional, manager) within each industrial sector (blue-collar, service, white-collar). Using blue-collar workers in blue-collar industries as the referent group, odds ratios and 95% CI s were estimated by conditional logistic regression with multiple imputation, matched for sex, age, admission date, and admitting hospital. Smoking and drinking were additionally controlled. Higher occupational class (professionals and managers) was associated with excess risk for CHD . Even after controlling for smoking and drinking, the excess odds across all industries remained significantly associated with CHD , being most pronounced among managers employed in service industries (odds ratio, 1.19; 95% CI , 1.08-1.31). On the other hand, the excess CHD risk in higher occupational class was offset by their lower risk for stroke (eg, odds ratio for professionals in blue-collar industries, 0.77; 95% CI , 0.70-0.85). Conclusions The occupational "gradient" in cardiovascular disease (with lower risk observed in higher status occupations) may not be a universal phenomenon. In contemporary Japanese society, managers and professionals may experience higher risk for CHD .
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