During the last 15 years, the research on job stress and cardiovascular diseases has been dominated by the job strain model developed by R. Karasek (1979) and colleagues (R. Karasek & T. Theorell, 1990). In this article the results of this research are briefly summarized, and the theoretical and methodological basis is discussed and criticized. A sociological interpretation of the model emphasizing theories of technological change, qualifications of the workers, and the organization of work is proposed. Furthermore, improvements with regard to measuring the job strain dimensions and to sampling the study base are suggested. Substantial improvements of the job strain research could be achieved if the principle of triangulation were used in the measurements of stressors, stress, and sickness and if occupation-based samples were used instead of large representative samples.