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Boss stressing you out? Skip the Dilbert cartoons and check your heart.

Employees who say their managers are passive, inconsiderate and uncommunicative were more likely to suffer from heart attacks, according to a Swedish study that looked at 3,122 working men's health records.

Those who thought well of their bosses were less likely to get heart disease, and the higher their opinion, the lower the risk, researchers found.

The study, published Tuesday by the journal Occupational and Environmental Medicine, is the first to establish a clear link between management style and employee heart health, and to show the effects over time.

Earlier research shows poor management causes employee burnout, depression and high blood pressure.

"You should take it seriously that you are stressed due to your manager," lead author Anna Nyberg, a psychologist at Karolinska Institute's Department of Public Health Sciences in Stockholm, said in a telephone interview Monday. "If you have a good boss, you have at least a 20 percent lower risk, and if you stay with your boss for four years, you have at least a 39 percent lower risk."

Researchers used a standardized stress test and examined hospital records. On average, participants at the study's start were 42 years old, highly educated and slightly overweight. Three out of four exercised "now and then" or regularly. The men filled out a section of the so-called stress profile on "leadership climate," scoring their bosses on such statements as "My boss is good at pushing through and carrying out changes."

Over the 10 years that participants were tracked, 74 had heart attacks or angina, all of which required hospitalization and some of which were fatal, the study found. Women weren't included because too few had heart problems.