Psychosocial Work Factors and Cardiovascular Disease Risk Among Middle-Level Managers in Nigerian Banks: A Case-Control Study

The relationship between psychosocial work stressors and cardiovascular disease (CVD) risk is well documented in high-income country literature, yet evidence from Nigerian occupational cohorts remains limited. This case-control study examined the association between psychosocial work factors and CVD risk markers among middle-level managers in commercial banks in Lagos State, South West Nigeria. One hundred cases with elevated CVD risk (defined by Framingham 10-year risk score above 10%) were matched 1:1 by age and sex with controls from the same institutions. Psychosocial work exposure was assessed using the validated Job Content Questionnaire (Karasek model) capturing job demand, control, and social support dimensions. Blood pressure, fasting lipid profiles, fasting glucose, and waist circumference were measured as CVD risk markers. High job demand-low control (high strain) profile was significantly more prevalent among cases (OR: 3.78, 95% CI: 2.11-6.77). Effort-reward imbalance (Siegrist model) showed a stronger association in female managers. Emotional exhaustion mediated 31.4 percent of the job strain-CVD risk pathway. This study provides new empirical evidence of the job strain-CVD relationship in a Nigerian banking context and recommends workplace stress management interventions, job redesign initiatives, and CVD risk screening programs for bank management staff in Lagos. Keywords: psychosocial work factors, cardiovascular risk, job strain, banking managers, Lagos State.