Objectives The aim of this study was to analyze the relationship of job strain (high psychological job demands and low decision latitude) to hypertension, serum lipids, and plasma fibrinogen.

Methods The study population consisted of employed persons between the ages of 15 and 64 years in the counties of Stockholm, Västernorrland, and Jämtland, Sweden. The data collection was carried out during 1992-1998. A total of 10 382 subjects participated in a medical examination and completed a questionnaire.

Results No strong associations were found between job strain and plasma fibrinogen. The males reporting job strain had lower levels of total cholesterol and high-density lipoprotein cholesterol than the other males. Similar tendencies were found for the females. The females, but not the males, with job strain had an increased prevalence of hypertension when compared with the subjects with relaxed psychosocial work characteristics. In the subgroups of younger males and females an adverse association between job strain and the ratio between low-density and high-density lipoprotein cholesterol was noted.

Conclusions The results do not support the hypothesis that job strain has an adverse impact on serum total cholesterol and plasma fibrinogen levels. They suggest that an increased risk of coronary heart disease in association with job strain, if causal, is mediated by other factors, possibly partly by hypertension and low levels of high-density lipoprotein cholesterol.

Key terms cholesterol; coronary heart disease; female; fibrinogen; high-density lipoprotein cholesterol; hypertension; job strain; lipids; male; risk factor; Sweden; work; work stress