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Managers who fire workers double heart attack risk

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Feel bad for folks who get fired? Maybe you should pity those who do the firing.

A study has found that managers run double their usual risk of a heart attack during the week after they give someone the ax.The research offers some of the strongest evidence yet that even brief spurts of on-the-job stress can be bad for the heart.

The study, conducted at 45 hospitals across the United States, attempted to see whether anything that happened at work in the days before people's heart attacks might have contributed to their health problems.

"The strongest effect was for working under a high-pressure deadline and having to fire someone," said Dr. Murray A. Mittleman of Beth Israel Deaconess Medical Center in Boston.

Most people probably already suspect that bad things at work might be hard on the heart. But there has been virtually no research to prove that a specific stressful incident can actually trigger a heart attack.

Some studies have suggested that chronic work stress - especially pressures that are beyond employees' direct control - contribute to heart disease. However, many experts are skeptical about how important this kind of stress really is, since just about everybody who works for a living has at least some daily job stress.

"What's different about this study is trying to individualize discrete episodes of stress, instead of having people simply saying, `I'm stressed,' " said Dr. Philip Greenland of Northwestern University, who was not involved in the study.

Mittleman presented his findings at an epidemiology meeting sponsored by the American Heart Association.

Between 1989 and 1994, doctors interviewed 791 working people who had just undergone heart attacks about what they had done recently. The researchers concluded that firing someone or having a high-stakes deadline doubled the usual risk of a heart attack during the following week.

Only two study participants had been recently fired - too few to suggest whether this too may trigger heart attacks - although Mittleman believes it probably does.

"The question is, what do we do about this?" Mittleman said.

The best advice, he said, is getting exercise, watching your weight, your cholesterol and your blood pressure, and not smoking.

For a healthy 50-year-old man, or a healthy 60-year-old woman, the risk of a heart attack in any given hour without any trigger is about 1 in a million. Even in a typical heart disease patient, the ordinary risk is 1 in 100,000.

The research project, called the Onset Study, has already identified several other daily stresses that can trigger a heart attack. These include heavy exertion, such as shoveling snow, angry outbursts, and simply getting up in the morning. It has exonerated coffee.