The risk appears to be highest for ischemic stroke, which occurs as a result of a blood clot blocking the flow of oxygen to the brain, and pertains mostly to women, according to the researchers.

Analyzing Job Types

Chinese researchers analyzed every published high-quality research study on job strain and stroke risk. They identified six that involved a total of 138,782 participants who ranged in age from 18 to 75 and were followed for three to 17 years.

Job types were separated into four categories using a model that measured two variables: psychological demand and control. Job demand accounts for psychological stressors such as deadlines, workplace conflicts, and mental load or concentration. It does not account for the amount of physical labor performed or the total number of hours worked, however. Control accounts for employees’ ability to solve problems, learn new skills, and make authoritative decisions that affect their work or workplace. Based on these variables, jobs were then classified as low strain (low demand and high control), passive (low demand and low control), high strain (high demand and low control), or active (high demand and high control).

Passive jobs include janitors, miners, and other manual laborers; low strain jobs include natural scientists and architects; high strain jobs include service industry occupations like servers and nurses aids; and active jobs include doctors, teachers, and engineers.

High Demand, Low Control Jobs Increase Stroke Risk

The researchers found that people with high strain jobs had a 22 percent higher risk of stroke than those with low strain jobs. Having a passive or active job was not associated with stroke risk, they said.

In a smaller analysis including five studies with data for 126,459 women and three studies with data for 12,323 men, stroke risk was found to be significant for women—33 percent higher for those with high strain jobs than those with low strain jobs—but not for men, possibly because there were fewer studies with male participants, the researchers said.

And in another analysis that looked at three studies of ischemic stroke in 76,000 participants and two studies of hemorrhagic stroke (caused by a burst blood vessel that bleeds into the brain) in 54,495 participants, high strain jobs significantly increased the risk for ischemic stroke—by 58 percent—but not hemorrhagic stroke.

Stressful Job/Stroke Link Is Unclear

 “It’s possible that high-stress jobs lead to more unhealthy behaviors, such as poor eating habits, smoking, and a lack of exercise,” said study author Dingli Xu, MD, a researcher in the department of cardiology at Southern Medical University in Guangzhou, China, in a news release.

Work stress has also been shown in past research to increase the risk for heart disease, which is a risk factor for stroke, noted Jennifer J. Majersik, MD, an associate professor of medicine at the University of Utah in Salt Lake City, in an accompanying editorial. High-stress jobs may also directly affect the brain, for example by promoting inflammation or over-stimulating the sympathetic nervous system, she said.

Reduce Stress, Reduce Risk

The study results suggest that giving employees more control on the job might help reduce their risk of stroke, said Dr. Majersik. Also, making sure they have access to psychological resources or therapy and allowing for more flexible work arrangements like telecommuting might help, she and the study authors said.

Staying healthy is also crucial, they emphasized. Here are three habits you can adopt right away:

• Cut Back on Salt, Fat, and Sugar. Choose fruits, vegetables, whole grains, and lean protein instead of processed foods.
• Raise Your Heart Rate. Aim to exercise for at least 30 minutes four times a week. Choose an activity you enjoy that gets your heart rate up, such as jogging, brisk walking, cycling, or swimming.
• Kick Butts. Smoking dramatically increases your risk of stroke, not to mention a heap of other health problems. Find other tips and resources to help you quit smoking.