A job that’s demanding but less than rewarding may take a toll on a man’s heart health, a study of nearly 6,500 white-collar workers suggested. Researchers found that men who habitually felt stressed on the job had up to twice the risk of developing heart disease.

In some cases, that stress took the form of “job strain,” which meant that workers felt pressure to perform but had little power over how to get their work done. In other cases, the central problem was “effort-reward imbalance.” That’s when employees feel their diligence is not winning adequate returns.

Men who reported either kind of job stress were about 50 percent more likely to develop heart disease over the next 18 years. The men who cited both types of job stress had twice the risk of their male counterparts who reported neither work issue. There was no similar effect seen among women.

 There are plenty of reasons that stress at work could contribute to heart disease. For one, chronic stress can directly affect the cardiovascular system, said Mathilde Lavigne-Robichaud, the lead researcher. “Job strain and effort-reward imbalance can trigger increased heart rate, higher blood pressure, and narrowing of blood vessels in the heart.”