e-Algerian Journal of Health & Research
Volume 2, Numéro 2, Pages 114-131
2026-04-26

Dissatisfaction At Work And Impact On Cardiovascular Risk : A Comprehensive Narrative Review Of Evidence

Authors : Bacha Aichouche . Liani Nora .

Abstract

Background : Cardiovascular diseases (CVD) remain the leading cause of mortality globally, accounting for 19.8 million deaths in 2022 (32% of all deaths). While the association between adverse psychosocial work environments and CVD has been extensively studied, the specific relationship between subjective job satisfaction and cardiovascular outcomes requires comprehensive synthesis. The 2024 European Society of Cardiology guidelines recognize psychosocial stressors as important modifiable risk factors requiring assessment. Objective: To conduct a comprehensive narrative review examining the association between job dissatisfaction and cardiovascular risk, including both clinical endpoints and intermediate risk factors, and to evaluate the underlying biological and behavioral mechanisms. Methods : We conducted a narrative review. Systematic searches were performed in PubMed, ScienceDirect, Web of Science, Scopus, and Cochrane Library from inception to March 2026. Eligible studies included longitudinal cohort studies, cross-sectional analyses, meta-analyses, and intervention trials examining job satisfaction and cardiovascular outcomes. Results : Over twenty studies met inclusion criteria. Evidence for hard cardiovascular endpoints (mortality, myocardial infarction) remains heterogeneous. The Scottish Cohort (n=6,498, 21-year follow-up) found no significant association with CVD mortality after adjustment (HR 1.05, 95% CI 0.90-1.23). However, the Whitehall II study (n=7,956) demonstrated 12% reduced CHD risk with higher job satisfaction (HR 0.88, 95% CI 0.81-0.95), primarily driven by angina rather than hard outcomes. Associations with intermediate risk factors were more consistent: hypertension (HR 1.29-1.54), metabolic syndrome (OR 1.78), and obesity, with combined lifestyle factors acting as significant mediators. Behavioral pathways (smoking, physical inactivity, poor diet) appear to be primary mediators, while physiological mechanisms (Hypothalamic-Pituitary-Adrenal axis activation, inflammatory markers) provide supplementary pathways. Conclusions : Job dissatisfaction represents a significant, modifiable marker of cardiovascular risk, primarily operating through behavioral and metabolic pathways. Future research should prioritize standardized, multidimensional assessment tools and longitudinal designs. Occupational health interventions should integrate psychosocial screening with biological risk factor monitoring.

Keywords

Job satisfaction ; Cardiovascular disease ; Occupational health ; Psychosocial factors ; Hypertension ; Metabolic syndrome ; Workplace intervention