Circadian rhythm of blood pressure is transformed from a dipper to a non-dipper pattern in shift workers with hypertension

Kitamura, Tatsuya; Onishi, Katsuya; Dohi, Kaoru; Okinaka, Tsutomu; M, Ito; Isaka, Naoki; Nakano, Takahiro

doi:10.1038/sj.jhh.1001328

Cited by 53 publications

(40 citation statements)

References 22 publications

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“…It is now well-accepted that inflammation has an important role in the development of cardiovascular disease and that each of the inflammatory markers we measured predicts cardiovascular disease (14,15,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Epidemiologic studies convincingly show an increased prevalence of cardiovascular disease in night workers versus day workers, and field studies in shift workers have shown increased blood pressure and inflammatory markers during or after night work compared with day work or days off (41)(42)(43)(44)(45). However, such studies can not definitively distinguish a possible causal role of circadian misalignment in the observed adverse health effects of shift work versus that of differences in other factors, such as work stressors, dietary habits, and physical activity, as well as family, financial, genetic, health, and social factors, etc.…”

Section: Discussionmentioning

confidence: 87%

“…In chronic shift workers, blood pressure is higher, and the day/night blood pressure rhythm is blunted while working night shifts compared with day shifts (41)(42)(43)(44)(45). Such study designs can not isolate the independent effect of circadian misalignment on blood pressure versus shift workinduced changes in factors such as diet, physical activity, light exposure, etc.…”

Section: Possible Mechanisms Involved In Circadian Misalignment-mediatedmentioning

confidence: 99%

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Circadian misalignment increases cardiovascular disease risk factors in humans

Morris

Purvis

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

474

343

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Shift work is a risk factor for hypertension, inflammation, and cardiovascular disease. This increased risk cannot be fully explained by classic risk factors. One of the key features of shift workers is that their behavioral and environmental cycles are typically misaligned relative to their endogenous circadian system. However, there is little information on the impact of acute circadian misalignment on cardiovascular disease risk in humans. Here we show-by using two 8-d laboratory protocols-that short-term circadian misalignment (12-h inverted behavioral and environmental cycles for three days) adversely affects cardiovascular risk factors in healthy adults. Circadian misalignment increased 24-h systolic blood pressure (SBP) and diastolic blood pressure (DBP) by 3.0 mmHg and 1.5 mmHg, respectively. These results were primarily explained by an increase in blood pressure during sleep opportunities (SBP, +5.6 mmHg; DBP, +1.9 mmHg) and, to a lesser extent, by raised blood pressure during wake periods (SBP, +1.6 mmHg; DBP, +1.4 mmHg). Circadian misalignment decreased wake cardiac vagal modulation by 8-15%, as determined by heart rate variability analysis, and decreased 24-h urinary epinephrine excretion rate by 7%, without a significant effect on 24-h urinary norepinephrine excretion rate. Circadian misalignment increased 24-h serum interleukin-6, C-reactive protein, resistin, and tumor necrosis factor-α levels by 3-29%. We demonstrate that circadian misalignment per se increases blood pressure and inflammatory markers. Our findings may help explain why shift work increases hypertension, inflammation, and cardiovascular disease risk.circadian misalignment | hypertension | inflammatory markers | night work | shift work

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Section: Discussionmentioning

confidence: 87%

Section: Possible Mechanisms Involved In Circadian Misalignment-mediatedmentioning

confidence: 99%

Circadian misalignment increases cardiovascular disease risk factors in humans

Morris

Purvis

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

474

343

View full text Add to dashboard Cite

show abstract

“…[13][14][15][16] It also has been shown that BP is high during nighttime working hours and low during daytime sleeping hours in shift workers, although the dip in BP during sleeping hours may be attenuated at the beginning of the night shift. 17,18 These results indicate that the endogenous clock has a minor role in the generation of BP variation associated with the awake and sleep cycle.…”

Section: Diurnal Bp Variation In Relation To Mental and Physical Actimentioning

confidence: 84%

Diurnal blood pressure variation and related behavioral factors

Kawano

2010

Hypertens Res

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Blood pressure (BP) varies according to many internal and external factors, and behavioral factors have an important role in diurnal BP variation. BP rises sharply on waking in the morning and falls during sleep at night, although it varies throughout the day and night. These changes in BP are closely related to mental and physical activities, and the sympathetic nervous system mainly contributes to the diurnal variation in BP. Other behavioral factors, such as food consumption and obesity, dietary intake of sodium, drinking and smoking habits, consumption of coffee and tea, and bathing, also affect the diurnal variation in BP. Alterations in diurnal BP variation due to behavioral factors are frequently seen in patients with hypertension and can be classified as morning hypertension, daytime hypertension and nighttime hypertension. Appropriate lifestyle modifications may normalize or improve both the level and rhythm of BP in these patients. Hypertension Research (2011) 34, 281-285; doi:10.1038/hr.2010.241; published online 2 December 2010Keywords: ambulatory blood pressure monitoring; diurnal blood pressure variation; lifestyle; mental stress; physical activity INTRODUCTION Blood pressure (BP) varies according to many internal and external factors. There are several distinctive rhythmic variations in BP including diurnal (or circadian) variation, and behavioral factors have an important role in diurnal BP variation. BP rises sharply on waking in the morning and falls during sleep at night, although it varies with changes in mental and physical activities during daytime and nighttime. [1][2][3][4] In addition to the awake and sleep cycle, many behavioral factors, such as mental stress, exercise, food consumption, changes in body weight, dietary intake of sodium and other electrolytes, drinking and smoking habits, consumption of coffee and tea, and bathing, influence both the level and variation in BP. [5][6][7][8] Understanding the influences of those behavioral factors on diurnal BP variation is important for the management of hypertension because alterations in diurnal BP variation due to behavioral factors are observed in many hypertensive subjects. 9,10 It has been shown that ambulatory BP monitoring is useful for assessing the influence of behavioral factors as well as the effects of lifestyle modifications on the level and pattern of BP throughout the day. 11,12 In this review article, I would like to summarize the effects of behavioral factors on diurnal BP variation with respect to the pathophysiology of hypertension and the effects of lifestyle modifications on 24-h BP.

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“…In a 24-hour monitoring study (121), blood pressure was higher during daytime sleep than sleep that occurred at night, a finding that may point to non-dipping phenomena but may also reflect the circadian variation of blood pressure. Kitamura et al (122) reported a transient effect of shift work on dipping at the beginning of night shift work. This was reversed to a dipping pattern after four days of work.…”

Section: Metabolic Syndrome (Mets)mentioning

confidence: 99%

Shift work and cardiovascular disease – pathways from circadian stress to morbidity

Puttonen

Härmä²,

Hublin³

2010

Scand J Work Environ Health

479

359

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Puttonen S, Härmä M, Hublin C. Shift work and cardiovascular disease -pathways from circadian stress to morbidity. Scand J Work Environ Health. 2010;36(2):96-108.In order to establish a causal relation between shift work and cardiovascular disease (CVD), we need to verify the pathways from the former to the latter. This paper aims to review the current knowledge of the mechanisms between shift work and CVD. Shift work can increase the risk of CVD by several interrelated psychosocial, behavioral, and physiological mechanisms. The psychosocial mechanisms relate to difficulties in controlling working hours, decreased work-life balance, and poor recovery following work. The most probable behavioral changes are weight gain and smoking. The plausible physiological and biological mechanisms are related to the activation of the autonomic nervous system, inflammation, changed lipid and glucose metabolism, and related changes in the risk for atherosclerosis, metabolic syndrome, and type II diabetes. The data provide evidence for possible disease mechanisms between shift work and CVD, but compelling evidence on any specific mechanism is missing.

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Circadian rhythm of blood pressure is transformed from a dipper to a non-dipper pattern in shift workers with hypertension

Cited by 53 publications

References 22 publications

Circadian misalignment increases cardiovascular disease risk factors in humans

Circadian misalignment increases cardiovascular disease risk factors in humans

Diurnal blood pressure variation and related behavioral factors

Shift work and cardiovascular disease – pathways from circadian stress to morbidity

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