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Cardiovascular disease prevention at the workplace: assessing the prognostic value of lifestyle risk factors and job-related conditions

Author

Listed:
  • Giovanni Veronesi

    (University of Insubria)

  • Rossana Borchini

    (Varese Hospital and University of Insubria)

  • Paul Landsbergis

    (SUNY Downstate Medical Center)

  • Licia Iacoviello

    (University of Insubria
    IRCCS Neuromed)

  • Francesco Gianfagna

    (University of Insubria
    IRCCS Neuromed)

  • Patrick Tayoun

    (University of Insubria)

  • Guido Grassi

    (University of Milano-Bicocca
    IRCCS Multimedica)

  • Giancarlo Cesana

    (University of Milano Bicocca)

  • Marco Mario Ferrario

    (University of Insubria
    Varese Hospital and University of Insubria)

Abstract

Objectives The prognostic utility of lifestyle risk factors and job-related conditions (LS&JRC) for cardiovascular disease (CVD) risk stratification remains to be clarified. Methods We investigated discrimination and clinical utility of LS&JRC among 2532 workers, 35–64 years old, CVD-free at the time of recruitment (1989–1996) in four prospective cohorts in Northern Italy, and followed up (median 14 years) until first major coronary event or ischemic stroke, fatal or non-fatal. From a Cox model including cigarette smoking, alcohol intake, occupational and sport physical activity and job strain, we estimated 10-year discrimination as the area under the ROC curve (AUC), and clinical utility as the Net Benefit. Results N = 162 events occurred during follow-up (10-year risk: 4.3%). The LS&JRC model showed the same discrimination (AUC = 0.753, 95% CI 0.700–0.780) as blood lipids, blood pressure, smoking and diabetes (AUC = 0.753), consistently across occupational classes. Among workers at low CVD risk (n = 1832, 91 CVD events), 687 were at increased LS&JRC risk; of these, 1 every 15 was a case, resulting in a positive Net Benefit (1.27; 95% CI 0.68–2.16). Conclusions LS&JRC are as accurate as clinical risk factors in identifying future cardiovascular events among working males. Our results support initiatives to improve total health at work as strategies to prevent cardiovascular disease.

Suggested Citation

  • Giovanni Veronesi & Rossana Borchini & Paul Landsbergis & Licia Iacoviello & Francesco Gianfagna & Patrick Tayoun & Guido Grassi & Giancarlo Cesana & Marco Mario Ferrario, 2018. "Cardiovascular disease prevention at the workplace: assessing the prognostic value of lifestyle risk factors and job-related conditions," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(6), pages 723-732, July.
  • Handle: RePEc:spr:ijphth:v:63:y:2018:i:6:d:10.1007_s00038-018-1118-2
    DOI: 10.1007/s00038-018-1118-2
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    References listed on IDEAS

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    1. Sorensen, G. & Landsbergis, P. & Hammer, L. & Amick III, B.C. & Linnan, L. & Yancey, A. & Welch, L.S. & Goetzel, R.Z. & Flannery, K.M. & Pratt, C., 2011. "Preventing chronic disease in the workplace: A workshop report and recommendations," American Journal of Public Health, American Public Health Association, vol. 101(SUPPL. 1), pages 196-207.
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    Cited by:

    1. Emilian Zadarko & Maria Zadarko-Domaradzka & Zbigniew Barabasz & Marek Sobolewski, 2022. "A Non-Exercise Model for Predicting Cardiovascular Risks among Apparently Healthy Male Office Workers—Cross-Sectional Analysis: A Pilot Study," IJERPH, MDPI, vol. 19(5), pages 1-13, February.

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