The influence of psychosocial work-related factors on the conventional risk factors of ischemic heart disease (IHD), particularly on the lipid changes and their effect on homocysteine is studied in this paper. Employed males aged 35 to 55 with angina pectoris or a myocardial infarction (IHD group) were compared to a group of individuals without ischemic heart disease (Control Group). Psychosocial factors were assessed using a Swedish Theorell questionnaire. The IHD Group was found to be at a higher risk of IHD due to higher work demands (OR = 1.25), worse job control (OR = 1.23), frequent smoking (OR = 2.2), leadership positions (OR = 3.97), higher BMI (p = 0.059) and higher levels of triglycerides (p = 0.005) and LDL-cholesterol (OR = 1.65). The level of HDL-cholesterol was significantly lower (1.0 vs. 1.4 mmol/L, p < 0.001, OR = 1.64), while the level of C-reactive protein (9.1 vs. 1.8 mg/L) and Interleukin-6 (6.5 vs. 1.6 ng/L) was higher. Homocysteine levels showed borderline significance (p = 0.056). Our study suggests a possible influence of psychosocial work-related factors on IHD risk factors, most of all on low HDL-cholesterol. No connection was found between psychosocial factors and the homocysteine level, shown to be an IHD risk factor at lower levels of approximately 10 micromol/L.