Ischaemic heart disease (IHD) is one of the Western world’s most widespread diseases and causes of death. Among the many risk factors for this condition, work-related psychosocial factors increase the risk of IHD independently of the conventional coronary risk factors (1). Because psychological stressors activate the physiological stress response, a patho-physiological explanation may be that long-term or repeated physiological stress due to work-related psychosocial factors may be atherogenic. Usually, theoretical stress models are used as the bases for self-report questionnaires, i.e., the Demand Control Model (DC model), and the Effort Reward Imbalance Model (ERI model), as these models (particularly the DC model) have been frequently examined, and several papers have shown associations between psychosocial load according to the models and different endpoints. The use of theoretically based stress models may be a strength of a design, but at the same time, it is important that the models do not rule out the exploration of other stressors. During the last 20 years or more, the labour market has changed, and fewer people are employed in production (e.g., industry and farming), whereas more people are employed in education, administration, health care, and knowledge production. This shift means that the stress models used in the 1980s might require further development to be used today. In the epidemiological setting, the physiological stress response can be measured non-invasively through the use of salivary cortisol and analysis of heart rate variability (HRV) (2). Cortisol is easily measured in the saliva, and saliva samples can be stored at room temperature for a long time before the cortisol decays, making this method appropriate for use in epidemiological studies, but great intra and between individual variations are the reason for methodological problems. Research using salivary cortisol as either an effect measure or an explanatory variable has recently been reviewed. The conclusion was that study design is of the utmost importance, but that the deviation measures, i.e., CAR or diurnal slope (decrease in cortisol from morning to evening), appear to be rather consistently associated with psychological factors, whereas a flat diurnal curve (low morning cortisol and high evening cortisol) appears to be associated with ill-health. Several reviews have concluded that work-related psychosocial factors are associated with salivary cortisol levels. Work stress may be considered to be a rather low stressor and so with presumably little physiological effect. Subsequently, the positive association between psychological strain at work and increased levels of cortisol may be interpreted as a normal physiological activation.HRV is defined as the spontaneous fluctuations in the sinus rhythm due to processes in the body. By analysing the variability of heart rhythms observed in an electrocardiogram (ECG), the activity in the autonomous nervous system can be evaluated. HRV, in the form of reduced values for time-domain analysis, is known to be associated with, among other things, heart disease and to predict illness and death. The association between HRV and IMT is still controversial, and future research on this issue is needed. The use of acute myocardial infarction (AMI) as an endpoint in stress research has been problematic. However, today, the individual’s level of atherosclerosis can be directly estimated by ultrasound examination of the walls of the arteries in the neck, and the intima media thickness of the vessel wall (IMT) may be considered to be a valid alternative for cardiovascular events as outcome. IMT and progression in IMT have both been linked to work-related psychosocial factors (3-5).The literature indicate that atherosclerosis may, independent of other risk factors, be provoked by psychosocial strain. In a population in which conventional coronary risk factors have low prevalence, i.e. younger people, greater focus on psychosocial factors might be important for the prevention of atherosclerosis. The use of physiological measurements for stress will be of great significance in connection with understanding work stress and the long-term effects of this condition.