Involuntary unemployment due to job loss has been associated with increased risk of
cardiovascular events. Whether it also is associated with increased risk of atrial
fibrillation (AF) is currently unknown. Therefore, we examined this association in
8,812 participants residing mainly in the Southeastern United States (mean age 58.1 ± 7.8
years; 63.2%; women; 43.2% black) with data on employment status who were enrolled
in the REasons for Geographic And Racial Differences in Stroke study between 2003
and 2007 after excluding those with voluntary unemployment (retiree, homemakers, and
students). AF was identified by electrocardiogram and past medical history at the
same period. The cross-sectional association between status and type of unemployment
with AF was examined in multivariable logistic regression models. Additional analysis
in 4,273 participants without baseline AF and with data on incident AF collected in
a follow-up visit occurred after a median of 9.4 years from baseline was also conducted.
In a model adjusted for socio-demographics, health insurance, income, perceived stress,
and cardiovascular risk factors, unemployment was associated with 60% increased odds
of AF (odds ratio [95% confidence interval] 1.60 (1.24, 2.07)). This association was
consistent in subgroups stratified by median age, gender, race, education, income,
and health insurance status. Similarly, unemployment was associated with AF in those
without AF at baseline who developed incident AF (odds ratio [95% confidence interval]
1.54 (1.04, 2.37)). In conclusion, involuntary unemployment is associated with increased
risk of AF. This may call for considering socioeconomic determinants such as unemployment
as part of the preventive strategies for AF.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Unemployment and cardiovascular diseases: a causal relationship?.Int Arch Occup Environ Health. 1997; 70: 153-160
- The cumulative effect of unemployment on risks for acute myocardial infarction.Arch Intern Med. 2012; 172: 1731-1737
- The impact of late career job loss on myocardial infarction and stroke: a 10 year follow up using the health and retirement survey.Occup Environ Med. 2006; 63: 683-687
- Associations between unemployment and cardiovascular risk factors varies with the unemployment rate: the Cardiovascular Risk Factor Study in Southern Sweden (CRISS).Scand J Public Health. 2003; 31: 305-311
- Anger and hostility predict the development of atrial fibrillation in men in the Framingham Offspring Study.Circulation. 2004; 109: 1267-1271
- Tension and anxiety and the prediction of the 10-year incidence of coronary heart disease, atrial fibrillation, and total mortality: the Framingham Offspring Study.Psychosom Med. 2005; 67: 692-696
- Triggering of symptomatic atrial fibrillation by negative emotion.J Am Coll Cardiol. 2014; 64: 1533-1534
- Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study.JAMA. 2001; 285: 2370-2375
- The reasons for geographic and racial differences in stroke study: objectives and design.Neuroepidemiology. 2005; 25: 135-143
- A global measure of perceived stress.J Health Soc Behav. 1983; 24: 385-396
- Self-reported atrial fibrillation and risk of stroke in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.Stroke. 2011; 42: 2950-2953
Article Info
Publication History
Published online: July 21, 2017
Accepted:
July 7,
2017
Received:
May 5,
2017
Footnotes
Funding Support: This research project is supported by a cooperative agreement U01 NS041588 from the National Institute of Neurological Disorders and Stroke , National Institutes of Health, Department of Health and Human Service. The authors thank the other investigators, the staff, and the participants of the REGARDS study for their valuable contributions. A full list of participating REGARDS investigators and institutions can be found at http://www.regardsstudy.org.
See page 1301 for disclosure information.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
