A study looked at almost 6,500 white-collar workers in Canada, including managers, technical staff and office workers.
Researchers questioned them to see if their work rewards, like recognition, pay rises and promotions, fell below the amount of effort they put in.
The study also measured ‘job strain’ - which was higher if a job was demanding and the employee had little control over their work tasks.
Men with either of these problems were almost 50 per cent more likely to end up with coronary heart disease.
Men with both work issues were twice as likely to develop coronary heart disease, when their health was tracked for an average of 18 years.
That is the same risk of the condition which comes from being obese.
Experts say decades of feeling unappreciated and stressed at work may raise blood pressure, put strain on the heart, or contribute to the hardened arteries which cause coronary heart disease.
There are 2.3 million people in the UK living with coronary heart disease (CHD), which happens when the heart’s blood supply is blocked by hardened arteries and often causes severe chest pain called angina and shortness of breath.
The study did not find a higher risk of CHD linked to work stress in women.
However this may have been because women typically develop the condition later in life, and it is less common for them.
Dr Mathilde Lavigne-Robichaud, who led the study from Laval University in Quebec, said: ‘Giving people more control over their work, more recognition and a better work-life balance could help to improve men’s heart health.
‘More research is needed on the effects of making work less stressful for women, but evidence suggests it would reduce their risk of depressive symptoms.
‘Considering the amount of time we all spend at work, these results are extremely important.’
People in the study were considered to have a demanding job based on questions including if they had many responsibilities and tight deadlines.
They had a lack of control if, for example, they had little say in their work tasks or decisions, or their job was insecure.
People with high demands and lack of control at work were categorised as having high job strain - putting them at a 49 per cent greater risk of CHD, the study suggests.
People answered nine questions on the effort they put in at work, and nine on work rewards, such as good pay and recognition.
If effort outweighed rewards, they were also found to have a 49 per cent higher risk of CHD.
That is comparable to the estimated 42 per cent risk of the heart condition linked to high cholesterol, and the 35 per cent risk linked to being a smoker.
It is also close to the 52 per cent risk linked to a family history of cardiovascular disease.
The study, published in the journal Circulation: Cardiovascular Quality and Outcomes, looked at 3,118 men free from heart disease, among whom 571 developed CHD over the 18 years they were tracked.
It included 3,347 women without heart disease, of whom 265 were diagnosed with CHD.
Even taking into account other stressful life events, total hours worked, and health factors like high blood pressure and high cholesterol, men were more likely to develop the heart condition if they had a high level of job strain or were not fully rewarded for their efforts.
Almost a quarter of people had one of these work issues.
Previous studies have shown mixed or inconclusive results on how work stress affects heart disease, but the researchers suggest these did not look at men and women separately, or track people’s health for long enough.