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Additional file 1: Table S1. ERI cross-sectional linear regression models selected with forward stepwise regression (factors shown in the order of selection) for four health and work related outcomes at the baseline (t0) or at the 5-year follow-up (t1). Table S2. COPSOQ cross-sectional linear regression models selected with forward stepwise regression (factors shown in the order of selection) for four health and work-related outcomes at the baseline (t0) or at the 5-year follow-up (t1). Table S3. Correlation matrix (Pearson correlation coefficients) for COPSOQ dimensions, outcomes (shaded in gray), age and sex at baseline. Table S4. Correlation matrix (Pearson correlation coefficients) for COPSOQ dimensions and outcomes (shaded in gray) between baseline and follow-up. Table S5. Correlation matrix (Pearson correlation coefficients) for ERI dimensions, outcomes (shaded in gray), age and sex at baseline. Table S6. Correlation matrix (Pearson correlation coefficients) for between ERI dimensions at baseline and follow-up. Table S7. ERI cross-sectional multivariable linear regression models (factors shown in the order of selection), and adjusted for age, sex, and socioeconomic status. Due to the model selection procedure, the models selected at t0 sometimes differ from the models selected at t1. Table S8. ERI prospective linear multivariable regression models (factors shown in the order of selection), and adjusted for age, sex, and socioeconomic status. Table S9. COPSOQ cross-sectional multivariable linear regression models (factors shown in the order of selection), and adjusted for age, sex, and socioeconomic status. Table S10. COPSOQ prospective linear multivariable regression models (factors shown in the order of selection), and adjusted for age, sex, and socioeconomic status.

IntroductionWork-life conflicts (WLC) may impact health, but few studies prospectively consider the impact of WLC on objective outcomes such as cardiovascular disease. Using data from the Gutenberg Health Study (GHS), we examined if WLC at baseline was associated with an increased five-year incidence of cardiovascular events (myocardial infarct, stroke, atrial fibrillation, peripheral artery disease, coronary artery disease, chronic heart failure, sudden cardiac death). We also considered if WLC was associated with incident hypertension and arterial stiffness and if the effects of WLC on cardiovascular health differ for men and women.MethodsA working subsample of the 15,010 GHS cohort participants completed the Copenhagen Psychosocial Questionnaire, which included five "work-privacy conflict" questions at baseline and at the five-year follow-up. Relative risks for incident hypertension due to increased WLC at baseline (WLC scores exceeding 60 out of 100) were estimated with Poisson regression in the subgroup of participants without hypertension at baseline (n = 2426). Categories of WLC at baseline and follow-up were also used to examine the risk of hypertension due to chronic/recurrent WLC. In this subgroup, we also examined the association between WLC as a continuous score ranging from 0 to 100 with change to arterial stiffness after five years using linear regression. Hazard ratios were estimated for incident cardiovascular events in a larger subsample of participants without prevalent cardiovascular disease at baseline (n = 3698) using Cox regression. We used various multivariable regression models to adjust for sex, age, socioeconomic status, occupational, household, and cardiovascular risk factors.ResultsWe found no association between WLC and incident hypertension or increased arterial stiffness. The fully-adjusted relative risk for WLC >60 at baseline and hypertension was 0.93 (95% 0.74-1.17). The risk of hypertension due to chronic/recurrent WLC >60 was increased but not statistically significant (RR = 1.13, 95% CI 0.83-1.54). Overall, hazard ratios for incident cardiovascular events were also not increased. However, stratifying the results by sex resulted in a hazard ratio of 1.47 (95% CI 0.54-3.98) for incident cardiovascular disease among women in the fully adjusted model.ConclusionsAlthough our results were not statistically significant, they indicate that WLC is negatively impacting the cardiovascular health of women. While these results need to be confirmed with additional research and a longer follow-up, interventions to prevent WLC will promote health and could be especially beneficial for women.

Additional file 1: Supplementary Table 1. Baseline characteristics for the hypertension analysis. Supplementary Table 2. Sensitivity analysis using the five-item mobbing instrument. Supplementary Table 3. Associations of mobbing at baseline with change in arterial stiffness (AS). Supplementary Table 4. Associations of incident and recurrent mobbing with incidence of hypertension. Supplementary Table 5. Associations of incident and recurring mobbing with change in arterial stiffness (AS).

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