Work stress and risk of death in men and women with and without cardiometabolic disease: a multicohort study Prof Mika Kivimäki, FMedSci, Jaana Pentti,

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Work stress and risk of death in men and women with and without cardiometabolic disease: a multicohort study Prof Mika Kivimäki, FMedSci, Jaana Pentti, MSc, Jane E Ferrie, PhD, Prof G David Batty, DSc, Solja T Nyberg, PhD, Markus Jokela, PhD, Prof Marianna Virtanen, PhD, Prof Lars Alfredsson, PhD, Prof Nico Dragano, PhD, Eleonor I Fransson, PhD, Prof Marcel Goldberg, MD, Prof Anders Knutsson, PhD, Prof Markku Koskenvuo, MD, Aki Koskinen, MSc, Prof Anne Kouvonen, PhD, Ritva Luukkonen, PhD, Tuula Oksanen, MD, Prof Reiner Rugulies, PhD, Prof Johannes Siegrist, PhD, Archana Singh-Manoux, PhD, Sakari Suominen, MD, Prof Töres Theorell, MD, Ari Väänänen, PhD, Prof Jussi Vahtera, MD, Prof Peter J M Westerholm, MD, Prof Hugo Westerlund, PhD, Marie Zins, PhD, Prof Timo Strandberg, MD, Prof Andrew Steptoe, DSc, Prof John Deanfield, FRCP The Lancet Diabetes & Endocrinology Volume 6, Issue 9, Pages 705-713 (September 2018) DOI: 10.1016/S2213-8587(18)30140-2 Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 1 Sample selection The Lancet Diabetes & Endocrinology 2018 6, 705-713DOI: (10.1016/S2213-8587(18)30140-2) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 2 Job strain and age-adjusted mortality Job strain and mortality in participants without (A) and with cardiometabolic disease (B) at baseline, and cumulative hazard in participants with cardiometabolic disease at baseline (C). The Lancet Diabetes & Endocrinology 2018 6, 705-713DOI: (10.1016/S2213-8587(18)30140-2) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 3 Mortality in men with cardiometabolic disease by job strain and lifestyle factors *Data available only from Whitehall II, WOLF-N, and WOLF-S. The Lancet Diabetes & Endocrinology 2018 6, 705-713DOI: (10.1016/S2213-8587(18)30140-2) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 4 Job strain and mortality in men with cardiometabolic disease and a favourable risk profile HRs are adjusted for age and study. In analyses of normotensive and non-dyslipidaemic participants, HRs are also adjusted for systolic and diastolic blood pressure and total cholesterol. HR=hazard ratio. *Analysis included all studies. †Analysis included Whitehall II, WOLF-N, and WOLF-S. ‡For a subgroup of participants with total cholesterol <5·0 mmol/L, the corresponding hazard ratio is 4·82 (95% CI 1·15–20·2) for those with job strain (three deaths among nine participants) compared with those without job strain (five deaths among 71 participants). §Antidiabetes (ATC A10), antihypertensive (ATC C02, C03, C07-C09), lipid-lowering (ATC C10AA), and anticoagulation (ATC B01) medication. ¶Analysis includes FPS, HeSSup, WOLF-S, WOLF-N. The Lancet Diabetes & Endocrinology 2018 6, 705-713DOI: (10.1016/S2213-8587(18)30140-2) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions