Work-related stress as a cardiovascular risk factor in police officers: a systematic review of evidence

Several studies suggest that work-related stress in police officers may be associated with an increased risk of cardiovascular diseases. A systematic review of studies is, however, still lacking. According to PRISMA statement, a systematic search of PubMed, ISI Web of Science, Cinahl and PsychInfo electronic databases was undertaken. Studies published in English between 1/1/2000 and 31/12/2016 were included. A studies quality assessment was performed using the Newcastle Ottawa scale (NOS). The preliminary search retrieved 752 records. After selection, 16 studies (total population 17,698) were retrieved. The average quality of studies was low. Exposure to stress in cross-sectional studies was inconstantly associated with hypertension, obesity, dyslipidaemia, and impaired glucose metabolism. In addition, there was a prevalence of positive studies showing an association between stress and cardiovascular disease morbidity. Studies of higher quality, such as longitudinal studies on large sample size, were more supportive of a significant positive association between stress and cardiovascular risk factors. Results were, however, often conflicting and inconsistent with regard to definitions and measurement of stress, features of individual study design, study conduct, and conclusions drawn. A sound precautionary principle would be to adopt worksite health promotion programs designed to implement stress management strategies in this category of workers.