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Overtime is bad for the heart

Gordon T. McInnes
DOI: http://dx.doi.org/10.1093/eurheartj/ehq116 First published online: 11 May 2010
This editorial refers to ‘Overtime work and incident coronary heart disease: the Whitehall II prospective cohort study’, by M. Virtanen et al. doi:10.1093/eurheartj/ehq124

‘work, work, work till you die’

C. S. Lewis, Surprised by Joy, 1955

The English author, whose most widely read works include the children's series ‘The Chronicles of Narnia’, seems to have recognized the danger of work more than half a century ago. Supporting evidence appears in the study of Virtanen et al.1 This is a study from the Whitehall II project examining the association between overtime work and incident coronary heart disease as assessed by the incidence of fatal coronary heart disease, clinically verified myocardial infarction, or definite angina in a large prospectively followed-up cohort of civil servants studied for an average of 11 years. After adjustment for different recognized cardiovascular risk factors, the results indicate a significant influence on fatal and non-fatal coronary heart disease in individuals working 3–4 h overtime per working day. Results were consistent for fatal coronary heart disease, non-fatal myocardial infarction, definite angina pectoris, and all-cause mortality, although the influence was not always statistically significant. Furthermore, for each of these variables, there was a trend for risk to be increased as the number of hours per day of overtime work increased, at least if examined categorically (1 h, 2 h, and 3–4 h). These findings may have implications for cardiovascular risk assessment in the western population and beyond.

A small proportion of the association appears to be explained by type A behavioural pattern which is recognized as a risk factor for coronary heart disease.2 Employees who undertake overtime may also be …

*Corresponding author. Tel: +44 141 211 2319, Fax: +44 141 211 2895, Email: g.t.mcinnes{at}clinmed.gla.ac.uk