This paper highlights the role of chronic psychosocial stress in accelerated ageing and age-associated degenerative diseases, referring to the free radical theory of ageing. Chronic work stress in midlife provides an illustrative case to explore these associations, with an emphasis on cardiovascular disease and its subclinical precursors. It is argued that lack of control at work and the experience of an imbalance between efforts spent and rewards received at work trigger continued stress reactions with adverse long term effects on health. These conditions impair the working person's successful self-regulation in a core social role in adult life – the work role. Self-efficacy and self-esteem, two important psychological components of well-being and health, are compromised if personal control and social reward are lacking. Selected empirical results derived from epidemiological and experimental investigations are reported to illustrate this argument. In particular, otherwise healthy middle-aged employees suffering from stress at work are twice as likely to report a new cardiovascular disease in a five year period compared with their less stressed colleagues. In another study, an increase in average ambulatory systolic blood pressure and heart rate is observed in a group of workers characterized by an imbalance between effort and reward at work. The implications of this research for improved quality of life and healthy ageing in early old age concern the provision of adequate social roles, which offer opportunities for experiencing continued personal control and social reward. At the socio-political level, new forms of social productivity in economic and non-monetarized sectors need to be developed.