Night-shift workers with high BP at elevated risk for cardiometabolic multimorbidity
Shift workers with hypertension who usually or always work night shifts had greater risk for cardiometabolic multimorbidity compared with day workers, researchers reported in the Journal of the American Heart Association.
Further, there was an increased likelihood of cardiometabolic multimorbidity in participants who reported more than 10 night shifts per month with a morning chronotype or with a duration of less than 7 hours or more than 8 hours of sleep, according to the study.
Shift work and cardiometabolic disease
“Growing evidence indicates that shift work is related to increased risk of cardiovascular disease, hypertension, type 2 diabetes and other adverse health outcomes in otherwise healthy individuals,” Yongping Bai, MD, and Xunjie Cheng, MD, of the department of geriatric medicine at Xiangya Hospital at Central South University in Changsha, China, and colleagues wrote. “Research has shown that there is a positive association between night-shift work and the risk of many common cardiometabolic diseases. However, we cannot assume that this association applies to the risk of cardiometabolic multimorbidity in patients with hypertension because research has also shown that one risk factor may exhibit distinct effects in different processes in the course of cardiometabolic diseases, such as from healthy state to the single cardiometabolic disease state, or the single cardiometabolic disease state to cardiometabolic multimorbidity.”
In a population-based and prospective cohort study, Bai and Cheng evaluated 36,939 participants with hypertension from the UK Biobank to observe the relationship between shift work and risk for cardiometabolic multimorbidity.
Researchers classified cardiometabolic multimorbidity as “coexistence of hypertension and diabetes, coronary heart disease or stroke.”
The researchers stratified the participants into four groups: day workers, shift workers with never/rarely night shifts, shift workers with some night shifts and shift workers with usually/always night shifts.
Lifetime employment information was also collected from some participants, and this allowed categorization of duration and frequency of night shifts. For that analysis, participants were identified as day workers, one to 10 night shifts per month or more than 10 night shifts per month.
Hypertension progression to cardiometabolic multimorbidity
Across the work schedule classifications, mean age ranged from 54 to 55 years and percentage of men ranged from 53% to 69%.
Median follow-up time was 11.6 years, and in that time, 5,935 participants developed cardiometabolic multimorbidity. After adjusting for all variables, researchers found that shift workers who usually/always had night shifts were linked to a 16% higher cardiometabolic multimorbidity risk (HR = 1.16; 95% CI, 1.02-1.31) when compared with day workers.
Additionally, for those who worked more than 10 night shifts per month, there was a 19% higher risk for cardiometabolic multimorbidity compared with day workers (HR = 1.19; 95% CI, 1.06-1.34).
In cross-classification analysis, researchers observed that cardiometabolic multimorbidity development was more pronounced in those with a morning chronotype who reported more than 10 night shifts per month (HR = 1.26; 95% CI, 1.02–1.56) or in those with less than 7 hours or more than 8 hours of sleep who had more than 10 night shifts per month (HR = 1.43; 95% CI, 1.19-1.72).
“Hypertension has been related to a higher risk of cognitive decline and dementia, including Alzheimer’s disease,” Bai and Cheng told Healio. “Future studies could investigate the association between shift work and the incidence of cognitive decline and dementia in hypertensive patients.”
For more information:
Yongping Bai, MD, can be reached at baiyongping@csu.edu.cn.
Xunjie Cheng, MD, can be reached at linqiuyucheng@163.com.
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