Search

Background: Cardiovascular disease (CVD) is a leading cause of mortality. Numerous investigations have linked occupational factors and CVD. Occupational factors such as overtime work have an enormous effect on the CVD risk of industrial workers. However, risk factors for CVD are not systematically reviewed in the workplace. The purpose of the paper is to review work-related risk factors for CVD. Methods: A systematic review of work-related CVD risk factors was performed, yielding 180 articles. All articles were assessed in relation to inclusion and exclusion criteria, resulting in 44 articles being reviewed. The sole inclusion criteria was work-related environmental factors and intra/inter-personal factors (psychosocial factors), which is based on the socioecological perspective. The articles were also assessed regarding the quality of each study using the scoring methods developed by Cesario et al. and Brown et al. Conclusion: The literature review demonstrated that work environment factors such as shift work, overtime work, and noise and chemical exposures; and psychosocial factors such as job stress, social support, and socioeconomic status cannot be explained or intervened by one single risk factor. Furthermore, certain occupational factors were shown to aggravate or attenuate other risk factors. The implication of these findings is to incorporate work-related environmental and psychosocial factors into assessment of the patient's CVD risks and intervention plan. Future research should also incorporate a well-defined conceptual framework to address the effects of work-related environmental and psychosocial factors on CVD among CVD patients. [ABSTRACT FROM AUTHOR]

Objectives. RA is associated with early ischaemic heart disease. This appears to be driven largely by the presence of chronic inflammation. Studies suggest that treatment with disease-modifying drugs such as MTX may reduce the incidence of cardiovascular events in RA. Anti-TNF therapies significantly reduce inflammation in RA. However, the extent to which these agents also reduce cardiovascular disease (CVD) is uncertain. The purpose of this study was to explore the effect of anti-TNF agents on CVD in RA using a systematic literature review.Methods. We searched for studies of adults with RA treated with TNF antagonists where cardiovascular outcomes were recorded using MEDLINE, EMBASE, Cochrane Database, Database of Abstracts and Reviews of Effects, Health Technology Appraisal, Science Citation Index and Clinical Evidence from 1989 to 2010. Conference proceedings for the British Society of Rheumatology, ACR and EULAR between 2005 and 2009 were hand searched. Two reviewers assessed abstracts for inclusion and then quality of selected papers was assessed.Results. A total of 1840 abstracts were identified and 20 articles were suitable for inclusion. Information was obtained on the effect of TNF antagonists on overall CVD events, myocardial infarction, strokes and heart failure.Conclusion. In many studies, TNF antagonists appear to reduce the likelihood of CVD in individuals with RA. Reassuringly, there does not appear to be an increased risk of cardiac failure. However, the reduction in CVD is not as consistently seen as with studies of MTX. [ABSTRACT FROM PUBLISHER]