The correlation between nursing workload and abnormal 24-h ambulatory blood pressure profiles in clinical nurses: a cross-sectional study

Jun 17, 2026Journal of hypertension

Nursing Workload Linked to Unusual 24-Hour Blood Pressure Patterns in Hospital Nurses

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Abstract

Abnormal blood pressure profiles in clinical nurses were characterized by a median 117.0/80.5 mmHg and high rates of abnormal circadian rhythms.

Four distinct blood pressure profiles were identified based on ambulatory monitoring: low SBP dipper, high SBP rhythm variability, low DBP dipper, and high DBP rhythm variability.
An increased number of patients admitted or transferred in is associated with a higher likelihood of abnormal SBP profiles.
A greater total number of patients assigned correlates with an increased risk of abnormal DBP profiles.
Having more patients with level II or below care needs appears to reduce the risk of abnormal DBP profiles.
Linear relationships exist between specific nursing workload factors and the risk of developing abnormal blood pressure profiles.

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OBJECTIVE: To analyze 24-h ambulatory blood pressure profiles among clinical nurses and investigate their correlation with nursing workload.

METHODS: This study enrolled 312 clinical nurses from a tertiary hospital in China between June 2024 and June 2025. All participants underwent 24-h ambulatory blood pressure monitoring. Latent profile analysis identified blood pressure profiles. Binary logistic regression identified workload indicators associated with abnormal profiles, and restricted cubic spline models assessed dose-response relationships.

RESULTS: Four profiles were identified: the low ambulatory SBP dipper group (SBP<111 mmHg, dipper≥49%), the high ambulatory SBP rhythm variability group (SBP≥111 mmHg, abnormal circadian rhythm≥54%), the low ambulatory DBP dipper group (DBP<72 mmHg, dipper≥46%), and the high ambulatory DBP rhythm variability group (DBP≥72 mmHg, abnormal circadian rhythm≥61%). An increased number of patients admitted or transferred in was associated with abnormal SBP profiles [odds ratio (OR) 1.496, 95% confidence interval (95% CI) 1.069-2.094]. An increased total number of patients assigned was associated with abnormal DBP profiles (OR 1.228, 95% CI 1.014-1.488), whereas a higher number of patients with level II or below care needs was protective (OR 0.777, 95% CI 0.645-0.937). All associations were linear and varied across subgroups, with broader patterns observed in the high-variability groups.

CONCLUSION: Abnormal blood pressure profiles in clinical nurses were characterized by elevated 24-h blood pressure (median 117.0/80.5 mmHg) and a high proportion of abnormal circadian rhythms (54.2% for SBP and 61.4% for DBP). Linear dose-response relationships exist between specific nursing workload and the risk of abnormal profiles.

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The correlation between nursing workload and abnormal 24-h ambulatory blood pressure profiles in clinical nurses: a cross-sectional study

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