Working Late, Courting Stroke

When Jeb Bush told a crowd in New Hampshire this past summer that people in the United Statesneedto “work longerhours,”presumably he didn’t know that working longer hours is associated with a higher risk of strokes. According to a recent review and meta-analysis in The Lancet, if people take his advice to heart and start working more than 55 hours a week, their stroke risk will climb (Kivimaki M et al. Lancet. doi:10.1016 /S0140-6736(15)60295-1 [published online August 19, 2015]). Theanalysis included25prospectivecohort studies involving a total of 603 838 men and women with no history of coronaryheartdiseasewhowere followedup for a mean of 8.5 years and 528 908men and womenwith no history of stroke whowere followed up for 7.2 years. The investigators found thatworking55hoursaweekormore was linked with a 33% increased risk of stroke and a 13% increased risk of coronary heart disease. The risk for stroke increased the more hours worked, with individuals working41 to48hours having a 10%higher risk, and thoseworking 49 to 54 hours having a 27% higher risk of stroke when compared with those who worked between 35 and 40 hours a week, an effect that remained stable regardless of sex or geographic location. According to the US Bureau of Labor Statistics, the average full-time worker in 2014 worked 42.5 hours (http://1.usa.gov /1hXjByB). Nearly 10% of nonagricultural workers worked between 49 and 59 hours a week, and among agricultural workers, 20.7%workedmorethan60hoursperweek (http://1.usa.gov/1NPhpWI). Hidden in those numbers are a lot of workersat risk forstroke.Thequestion, then, is what to do about it.