Association of Shift Work and Lifestyle With Aortic Aneurysm Incidence: A Large Prospective Cohort Study in the UK Biobank

Jun 4, 2025Journal of the American Heart Association

How Shift Work and Lifestyle Are Linked to Aortic Aneurysm Risk in UK Adults

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Abstract

Among 213,971 participants, 1,035 developed aortic aneurysm (AA) during a mean follow-up of 14.9 years.

Shift work is associated with a significantly higher risk of aortic aneurysm (hazard ratio 1.24).
Frequent shift workers exhibit an even greater risk of developing AA (hazard ratio 1.27).
A dose-dependent relationship is observed, where the risk of AA increases with a higher unhealthy lifestyle score.
The combination of shift work and unhealthy lifestyle factors is significantly associated with an increased risk of AA, especially in those with 4 to 5 unhealthy factors (hazard ratio 2.26).
Unhealthy lifestyle factors, such as smoking, may contribute to the increased risk of AA among shift workers.

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BACKGROUND: Shift work is associated with various health problems, but its impact on aortic aneurysm (AA) is unclear. The role of lifestyle factors in this regard is also less clear. This study aimed to explore the combined effects of shift work and lifestyle on AA risk.

METHODS: A total of 213971 employed or self-employed participants from the UK Biobank were included in the study. Employment and lifestyle information was collected. Cox proportional hazards regression models were applied to assess the association between shift work and AA. Restricted cubic spline functions, mediation, interaction, and joint analyses were used to further explore the relationship between unhealthy lifestyle, shift work, and AA risk.

RESULTS: Among 213 971 participants, 1035 developed AA during a mean follow-up of 14.9 years. In fully adjusted models, shift work was associated with a significantly higher risk of AA (hazard ratio [HR], 1.24 [95% CI, 1.06-1.46]), with frequent shift workers showing an elevated risk (HR, 1.27 [95% CI, 1.03-1.57]). A dose-dependent relationship was observed between the unhealthy lifestyle score and the risk of AA, with the risk of AA increasing as the unhealthy lifestyle score increased. The joint effect of shift work and unhealthy lifestyle showed a significant association, particularly among shift workers with 4 to 5 unhealthy lifestyle factors (HR, 2.26 [95% CI, 1.63-3.14]).

CONCLUSIONS: In this cohort study, we found that shift work was significantly associated with an increased risk of AA. Additionally, unhealthy lifestyles, particularly smoking, may play a crucial role in this association. These findings underscore the need for targeted prevention strategies, especially for shift workers with unhealthy lifestyle factors.

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Association of Shift Work and Lifestyle With Aortic Aneurysm Incidence: A Large Prospective Cohort Study in the UK Biobank

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