OBJECTIVE: Investigate if the association between perceived psychological work pressure and risk of stroke is modified by socioeconomic status.

METHODS: Thirty-year follow-up of 4943 middle-aged men without cardiovascular disease.

RESULTS: In the higher social classes (I, II, and III), perceived regular exposure to psychological work pressure was common and a significant predictor of stroke; almost 10% of the stroke events could be attributed to this exposure in the higher social classes; among lower social classes (IV and V), perceived psychological pressure was no predictor at all.

CONCLUSIONS: Regular psychological work pressure is a highly prevalent and independent risk factor for stroke among men in higher social classes. In contrast, no association to stroke risk was found among low social class men.