The research is the first large-scale study to look at the cardiovascular mechanisms of work stress in the population and provides the strongest evidence yet of the way it can lead to coronary heart disease (CHD), either directly, by activating stress pathways controlled by the interaction between the nervous system, the endocrine glands and their hormones (neuroendocrine mechanisms), or indirectly via its association with unhealthy lifestyles.

The research is part of the long-running Whitehall II study, which has been following 10,308 London-based civil servants since 1985, and which is led by Sir Michael Marmot, professor of epidemiology and public health at University College London, UK.

Dr Tarani Chandola, a senior lecturer in UCL's Department of Epidemiology and Public Health, the first author of this EHJ study, said: "Stress at work is associated with an increased risk of coronary heart disease but the mechanisms underlying this association have remained unclear until now.