Effects of 24-h Shift Work in the Emergency Room on Ambulatory Blood Pressure Monitoring Values of Medical Residents

Fialho, Guilherme Loureiro; Cavichio, Luciano; Póvoa, Rms; Pimenta, João

doi:10.1016/j.amjhyper.2006.03.007

Cited by 33 publications

(24 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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: 86%

“…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%

See 1 more Smart Citation

Circadian misalignment increases cardiovascular disease risk factors in humans

Morris

Purvis

et al. 2016

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

472

343

View full text Add to dashboard Cite

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

show abstract

Section: Discussionmentioning

confidence: 86%

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.

472

343

View full text Add to dashboard Cite

show abstract

“…In a study by Yamasaki et al (118), shift workers had a smaller drop in the systolic blood pressure during sleep than day workers, and they were more often categorized as "non-dippers". Shift work has also been associated with higher 24-hour blood pressure levels (119,120), while the risk of non-dipper status yielded mixed results. The mean systolic blood pressure during a 24-hour measurement has been found to be higher among shift than day workers (110).…”

Section: Metabolic Syndrome (Mets)mentioning

confidence: 95%

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

Puttonen

Härmä²,

Hublin³

2010

Scand J Work Environ Health

479

359

View full text Add to dashboard Cite

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.

show abstract

“…The cohort consists of 18,558 individuals: born in one week in March 1958 in England, Scotland and Wales (17,638) with the addition of immigrants (n = 920) with the same birth dates up to age 16 years [23]. At 45 years, 11,971 cohort members who had not died or emigrated, were still in contact with the survey, and who were able to provide informed consent were invited to a clinical examination undertaken in their home by a trained nurse; 9,377 (78%) participated.…”

Section: Study Sample and Designmentioning

confidence: 99%

“…Night-work is estimated to increase the risk of coronary heart disease (CHD) by 40% [7]. Adverse changes have also been reported for a range of CVD risk factors although findings are inconsistent due to methodological differences [8][9][10][11][12][13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Shift work and risk factors for cardiovascular disease: a study at age 45 years in the 1958 British birth cohort

Thomas

Power

2010

Eur J Epidemiol

View full text Add to dashboard Cite

This study examined associations between exposure to shift-work and risk factors for cardiovascular disease (CVD) and whether the associations are explained by socio-economic circumstances, occupational factors or health behaviours. Biological risk factors for CVD were measured in 7,839 participants of the 1958 British birth cohort at age 45 years who were in paid employment. Regular (C1/week) shift-workers included 46% working evenings (1800-2200), 28% weekends, 13% nights (2200-0400) and 14% early mornings (0400-0700). Adverse levels of several CVD risk factors were found in association with increasing participation in any shift-work. Men regularly working all four shift-work types had increased CVD risk factors of approximately 0.1-0.2 standard deviations (e.g. 0.8 kg/m 2 for body mass index; 1.2 cm for waist circumference) than those not regularly working shifts; for women, there was a positive linear trend for triglyceride levels, but a negative trend for diastolic blood pressure. Separate analyses of shift-work types showed associations primarily for night/morning working rather than evening/ weekend working. Men had adverse levels of all CVD risk factors except blood pressure and total-cholesterol in association with night or early morning work and women had adverse triglyceride levels. Adjustment for socioeconomic, occupational factors and health behaviours explained most associations except for adiposity and C-reactive protein. Our results highlight night and early morning working associations with an adverse profile of CVD risk factors, which are partly explained by socioeconomic, other occupational factors and health behaviours.

show abstract

Effects of 24-h Shift Work in the Emergency Room on Ambulatory Blood Pressure Monitoring Values of Medical Residents

Abstract: Working in the ER on a 24-h shift leads to abnormal BP behavior in medical residents, thus suggesting that this type of work may be a risk factor for cardiovascular disease.

Cited by 33 publications

References 20 publications

Circadian misalignment increases cardiovascular disease risk factors in humans

Circadian misalignment increases cardiovascular disease risk factors in humans

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

Shift work and risk factors for cardiovascular disease: a study at age 45 years in the 1958 British birth cohort

Contact Info

Product

Resources

About