Your Health Checkup: Stop and Smell the Roses

Returning to long hours at work after a heart attack may be bad for your health.

A frustrated office employee rubs his temple while working late hours.
(Stokkete / Shutterstock)

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“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive. 

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In more than fifty years of practice as a cardiologist, I’ve never had a critically ill patient say, “I wish I’d spent more time at the office.” Rather, the lament has always been, “I wish I’d spent more time with my family, working fewer hours, taking vacations, and just enjoying life.”

There is solid science to back up those regrets.

In a recent study of almost a thousand men and women age 35 to 59 years who returned to work after a first heart attack, participants working more than 55 hours per week had a 67 percent increased risk of recurrent coronary heart disease events such as heart attacks and angina when compared with those working 35 to 40 hours per week. The risk progressively increased as the work week increased past 40 hours and when long working hours were combined with job strain. Stressful jobs with high demand or high effort and low reward more than doubled the risk. Interestingly, the negative effect of long working hours increased approximately four years following the return to work, suggesting chronic exposure to the work environment plays a role.

Naturally, I would advise my patients to reduce the number of working hours and/or the stress of the job. Often, they were unable to do so, or would counter that their job required significant physical exertion and therefore provided them with healthy exercise.

Recent information suggests that the latter reasoning is false.

A study just published of over 100,000 men and women aged 20-100 years who were followed for ten years found that higher physical activity during leisure time reduced major adverse cardiovascular events and risk of death while higher physical activity during work hours increased cardiovascular risk and risk of death. The authors called this the “physical activity paradox.” I wonder whether people performing hard physical labor are different socioeconomically from those who can afford to play tennis or golf. Since low income is a big cardiovascular risk factor, the poorer you are, the harder you might have to work physically.

While the obvious take-home message is to maintain working hours to 40 hours per week or less, that may not be achievable in many occupations. A fifth of the worldwide work force totaling more than 600 million people toils more than 48 hour per week. Americans work an average of 34.4 hours per week, so most Americans do achieve this end point. However, significant variations exist according gender, age, marital status, race, ethnicity, location, type of job, and education level. I rarely worked less than 50 to 60 hours per week as a cardiologist until reaching my most senior years. That is probably true for many people.

We should all take these numbers to heart, literally! The admonition attributed to the famous golf professional, Walter Hagen, to “stop and smell the roses,” sounds like a good idea, especially during this pandemic.

Featured image: (Stokkete / Shutterstock)

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