Shift Work and the Risk of Cardiometabolic Multimorbidity Among Patients With Hypertension: A Prospective Cohort Study of UK Biobank

Aug 29, 2022Journal of the American Heart Association

Shift Work and the Risk of Multiple Heart and Metabolic Diseases in People with High Blood Pressure

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Abstract

Among 36,939 UK Biobank participants, usually or always night shift workers have a 16% higher risk of cardiometabolic multimorbidity compared to day workers.

The incidence of cardiometabolic multimorbidity (CMM) includes conditions such as hypertension, diabetes, coronary heart disease, or stroke.
A higher frequency of night shifts (more than 10 per month) is linked to an increased risk of CMM.
The risk associated with high frequency of night shifts is intensified for individuals with a morning chronotype or those sleeping less than 7 hours or more than 8 hours.
During a median follow-up of 11.6 years, 5,935 participants developed CMM.

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Background Although the association between shift work and individual cardiometabolic diseases has been well studied, its role in the progression to cardiometabolic multimorbidity (CMM) remains unclear. In this study, we investigate the association between shift work and the incidence of CMM in patients with hypertension. Methods and Results This study is a population-based and prospective cohort study on 36 939 UK Biobank participants. We used competing risk models to examine the association between shift work and the risk of CMM, which was defined as coexistence of hypertension and diabetes, coronary heart disease, or stroke in our study. We also investigated the association between the frequency and duration of shift work and CMM risks. In addition, we conducted a cross-classification analysis with the combination of frequency and duration of shift work, chronotype and sleep duration as the exposure metrics. During a median follow-up of 11.6 years, a total of 5935 participants developed CMM. We found that usually/always night shift workers were associated with a 16% higher risk of CMM compared with day workers (hazard ratio [HR], 1.16 [95% CI, 1.02-1.31]). We also found that a higher frequency of night shifts (>10/month) was associated with increased risk of CMM (HR, 1.19 [95% CI, 1.06-1.34]) that was more pronounced for >10/month in combination with a morning chronotype or <7 hours or >8 hours of sleep duration (HR, 1.26 [95% CI, 1.02-1.56]; HR, 1.43 [95% CI, 1.19-1.72], respectively). Conclusions We find that night shift work is associated with higher CMM risk in patients with hypertension.

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Shift Work and the Risk of Cardiometabolic Multimorbidity Among Patients With Hypertension: A Prospective Cohort Study of UK Biobank

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