Impact of Shift Work and Race/Ethnicity on the Diurnal Rhythm of Blood Pressure and Catecholamines

Abstract

Abstract-To evaluate the effects of shift work and race/ethnicity on the diurnal rhythm of blood pressure and urinary catecholamine excretion of healthy female nurses, 37 African American women and 62 women of other races underwent ambulatory blood pressure monitor and urine collection for 24 hours that included a full work shift: day shift (nϭ61), evening shift (nϭ11), and night shift (nϭ27). Awake and sleep times were evaluated from subjects' diaries. Of African Americans, 79% who were working evenings or nights and 32% working day shifts were nondippers (Ͻ10% drop in systolic pressure during sleep), whereas only 29% of others working eveningϩnight and 8% working day shifts were nondippers. Regression analyses indicated that eveningϩnight shift workers had a 5.4 mm Hg (PϽ0.001) smaller drop than day shift workers, and African Americans had a 4.0 mm Hg (PϽ0.01) smaller drop than others. The odds of an eveningϩnight shift worker being a nondipper were 6.1 times that of a day shift worker (PϽ0.001), and the odds of an African American were 7.1 times that of others (PϽ0.001). Total sleep time was significantly greater in the non-African American day shift workers than in the other 3 groups. After controlling for work shift and race/ethnicity, we determined that longer sleep times predicted less dipping (absolute and relative) in blood pressure. Urinary norepinephrine and epinephrine were higher during work than nonwork in both racial groups of day shift workers, but in eveningϩnight shift workers the difference was small and in the opposite direction. These results indicate that being African American and working evening or night shifts are independent predictors of nondipper status. Higher sleep blood pressure may contribute to the known adverse effects of shift work. (Hypertension. 1998;32:417-423.)

Aromatherapy alleviates endothelial dysfunction of medical staff after night-shift work: preliminary observations

“…Several risk factors were exacerbated by night-shift work. [3][4][5][6][7][8] However, elimination of night-shift work is unlikely to be possible for most medical staff, although reduction in the frequency and duration of shifts is recommended. 1,21 Aromatherapy is a relatively inexpensive way to reduce anxiety that does not involve side effects.…”

“…Night-shift work disrupts the normal biological and/or social diurnal rhythms, which are factors in cardiovascular disease, 1,2 as well as in a widening variety of other chronic diseases, including glucose intolerance, 3,4 hypertension 5,6 and depression. 7,8 Endothelium function, which is strongly associated with the onset and development of cardiovascular disease and its risk factors, [9][10][11] has been shown to be impaired after night-shift work.…”

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

“…Yamasaki et al 10 suggested that more night shift workers than day workers are as non-dippers, probably because the quality of sleep was impaired by shift work, and sleep deprivation may induce high nocturnal BP. 10,13 Unfortunately, they did not obtain reports of sleep quality from their subjects.…”

“…10,13 Unfortunately, they did not obtain reports of sleep quality from their subjects. In our study, the quality of sleep did not differ between NS I and NS II, although, according to their diaries, night-shift work impaired the quality of sleep in comparison with day-shift work.…”

“…[7][8][9] A recent study on shift workers suggests that night-shift workers are more likely to be classified as non-dippers than are day workers. 10 However, it is not clear if a dipper pattern in hypertensive shift workers would change to a non-dipper pattern if the workers changed from a day shift to a night shift.…”