Shift work and risk of stroke: A meta-analysis

Li, Min; Huang, Jun; Tan, Yuan; Yang, Baoping; Tang, Zhenyu

doi:10.1016/j.ijcard.2016.03.052

Cited by 32 publications

(36 citation statements)

References 23 publications

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“…Among those articles, 41 (85%) used shift work as the exposure, and 12 (25%) used long work hours. The articles covered the following outcomes: cancers [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] (16, 33%), cardiovascular disease [33][34][35][36][37][38][39][40][41] (9, 19%), metabolic syndrome, diabetes mellitus, and obesity [42][43][44][45][46][47][48][49][50] (9, 19%), complications of pregnancy [51][52][53][54][55][56][57][58] (8, 17%), depression [43,45,59] (4, 8%), hypertension [60] (1, 2%), and injuries [61] (1, 2%). Some conditions we identified to be chronic or high cost (e.g.…”

Section: Overview Of Search Resultsmentioning

confidence: 99%

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Shift work and long work hours and their association with chronic health conditions: A systematic review of systematic reviews with meta-analyses

et al. 2020

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Background Previous reviews have demonstrated that shift work and long work hours are associated with increased risk for chronic conditions. However, these reviews did not comprehensively assessed the body of evidence, and some were not conducted in a systematic manner. A better understanding of the health consequences of shift work and long work hours will aid in creating policy and practice recommendations. This review revisits the epidemiologic evidence on the association of shift work and long work hours with chronic conditions with particular emphasis on assessing the quality of the evidence. Methods and findings We conducted a systematic review of systematic reviews with meta-analyses (SR-MA) that assessed the link between shift work or long work hours and chronic conditions (PROS-PERO CRD42019122084). We evaluated the risk of bias of each SR-MA using AMSTAR v2 and assessed the overall evidence for each condition using the GRADE approach. We included 48 reviews covering cancers, cardiovascular diseases, metabolic syndrome and related conditions, pregnancy complications, depression, hypertension, and injuries. On average, only 7 of 16 AMSTAR items were fulfilled. Few SR-MAs had a registered protocol and nearly all failed to conduct a comprehensive search. We found moderate grade evidence linking shift work to breast cancer and long work hours to stroke. We found low grade evidence linking both shift work and long work hours with low to moderate increase in risk for some pregnancy complications and cardiovascular diseases. Low grade evidence also link long work hours and depression. Conclusions Moderate grade evidence suggest that shift work and long work hours increase the risk of breast cancer and stroke, but the evidence is unclear on other chronic conditions. There is a

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Section: Overview Of Search Resultsmentioning

confidence: 99%

“…Six SR-Mas [33,[36][37][38]40,41] investigated the association between cardiovascular disease and shift work. We found low grade evidence for ischemic heart disease, myocardial infarction, and ischemic stroke.…”

Section: Shift Workmentioning

confidence: 99%

Shift work and long work hours and their association with chronic health conditions: A systematic review of systematic reviews with meta-analyses

et al. 2020

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“…Quality assessment of the studies was based on the Newcastle-Ottawa quality assessment scale for observational studies,20 where a study is judged based on selection (four items, one point each), comparability (one item, up to two points), and exposure/outcome (three items, one point each), up to a maximum score of nine points. The quality of the studies was graded as poor (fewer than four points), fair (four to six points), and good (seven or more points) 21. We also evaluated whether the studies had been adequately adjusted for potential confounders, that is, if they included at least five of six risk factors: sex; age; smoking; blood pressure, hypertension, or antihypertensive treatment; body mass index or other measures of overweight or obesity; and hypercholesterolaemia or serum concentrations of cholesterol 2223…”

Section: Methodsmentioning

confidence: 99%

“…The quality of the studies was graded as poor (fewer than four points), fair (four to six points), and good (seven or more points). 21 We also evaluated whether the studies had been adequately adjusted for potential confounders, that is, if they included at least five of six risk factors: sex; age; smoking; blood pressure, hypertension, or antihypertensive treatment; body mass index or other measures of overweight or obesity; and hypercholesterolaemia or serum concentrations of cholesterol. 22 23 …”

Section: Methodsmentioning

confidence: 99%

Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis

Cai

Zhang

et al. 2020

BMJ

398

311

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Objective To evaluate the associations between prediabetes and the risk of all cause mortality and incident cardiovascular disease in the general population and in patients with a history of atherosclerotic cardiovascular disease. Design Updated meta-analysis. Data sources Electronic databases (PubMed, Embase, and Google Scholar) up to 25 April 2020. Review methods Prospective cohort studies or post hoc analysis of clinical trials were included for analysis if they reported adjusted relative risks, odds ratios, or hazard ratios of all cause mortality or cardiovascular disease for prediabetes compared with normoglycaemia. Data were extracted independently by two investigators. Random effects models were used to calculate the relative risks and 95% confidence intervals. The primary outcomes were all cause mortality and composite cardiovascular disease. The secondary outcomes were the risk of coronary heart disease and stroke. Results A total of 129 studies were included, involving 10 069 955 individuals for analysis. In the general population, prediabetes was associated with an increased risk of all cause mortality (relative risk 1.13, 95% confidence interval 1.10 to 1.17), composite cardiovascular disease (1.15, 1.11 to 1.18), coronary heart disease (1.16, 1.11 to 1.21), and stroke (1.14, 1.08 to 1.20) in a median follow-up time of 9.8 years. Compared with normoglycaemia, the absolute risk difference in prediabetes for all cause mortality, composite cardiovascular disease, coronary heart disease, and stroke was 7.36 (95% confidence interval 9.59 to 12.51), 8.75 (6.41 to 10.49), 6.59 (4.53 to 8.65), and 3.68 (2.10 to 5.26) per 10 000 person years, respectively. Impaired glucose tolerance carried a higher risk of all cause mortality, coronary heart disease, and stroke than impaired fasting glucose. In patients with atherosclerotic cardiovascular disease, prediabetes was associated with an increased risk of all cause mortality (relative risk 1.36, 95% confidence interval 1.21 to 1.54), composite cardiovascular disease (1.37, 1.23 to 1.53), and coronary heart disease (1.15, 1.02 to 1.29) in a median follow-up time of 3.2 years, but no difference was seen for the risk of stroke (1.05, 0.81 to 1.36). Compared with normoglycaemia, in patients with atherosclerotic cardiovascular disease, the absolute risk difference in prediabetes for all cause mortality, composite cardiovascular disease, coronary heart disease, and stroke was 66.19 (95% confidence interval 38.60 to 99.25), 189.77 (117.97 to 271.84), 40.62 (5.42 to 78.53), and 8.54 (32.43 to 61.45) per 10 000 person years, respectively. No significant heterogeneity was found for the risk of all outcomes seen for the different definitions of prediabetes in patients with atherosclerotic cardiovascular disease (all P>0.10). Conclusions Results indicated that prediabetes was associated with an increased risk of all cause mortality and cardiovascular disease in the general population and in patients with atherosclerotic cardiovascular disease. Screening and appropriate management of prediabetes might contribute to primary and secondary prevention of cardiovascular disease.

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“…In this meta-analysis we graded quality as good (≥7 stars), fair (4-6 stars), and poor (<4 stars). 23 24 We also evaluated whether the studies had adequately adjusted for potential confounders (at least five of six confounders including sex, age, hypertension or blood pressure or antihypertensive treatment, body mass index (BMI) or other measure of overweight/obesity, cholesterol, and smoking). statistical analysis Primary outcomes were relative risks for composite cardiovascular events and all cause mortality.…”

Section: Patient Involvementmentioning

confidence: 99%

Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis

Huang

Cai

Mai

et al. 2016

BMJ

734

560

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Objectives To evaluate associations between different definitions of prediabetes and the risk of cardiovascular disease and all cause mortality.Design Meta-analysis of prospective cohort studies.Data sources Electronic databases (PubMed, Embase, and Google Scholar).Selection criteria Prospective cohort studies from general populations were included for meta-analysis if they reported adjusted relative risks with 95% confidence intervals for associations between the risk of composite cardiovascular disease, coronary heart disease, stroke, all cause mortality, and prediabetes.Review methods Two authors independently reviewed and selected eligible studies, based on predetermined selection criteria. Prediabetes was defined as impaired fasting glucose according to the criteria of the American Diabetes Association (IFG-ADA; fasting glucose 5.6-6.9 mmol/L), the WHO expert group (IFG-WHO; fasting glucose 6.1-6.9 mmol/L), impaired glucose tolerance (2 hour plasma glucose concentration 7.8-11.0 mmol/L during an oral glucose tolerance test), or raised haemoglobin A1c (HbA1c) of 39-47 mmol/mol(5.7-6.4%) according to ADA criteria or 42-47 mmol/mol (6.0-6.4%) according to the National Institute for Health and Care Excellence (NICE) guideline. The relative risks of all cause mortality and cardiovascular events were calculated and reported with 95% confidence intervals.Results 53 prospective cohort studies with 1 611 339 individuals were included for analysis. The median follow-up duration was 9.5 years. Compared with normoglycaemia, prediabetes (impaired glucose tolerance or impaired fasting glucose according to IFG-ADA or IFG-WHO criteria) was associated with an increased risk of composite cardiovascular disease (relative risk 1.13, 1.26, and 1.30 for IFG-ADA, IFG-WHO, and impaired glucose tolerance, respectively), coronary heart disease (1.10, 1.18, and 1.20, respectively), stroke (1.06, 1.17, and 1.20, respectively), and all cause mortality (1.13, 1.13 and 1.32, respectively). Increases in HBA1c to 39-47 mmol/mol or 42-47 mmol/mol were both associated with an increased risk of composite cardiovascular disease (1.21 and 1.25, respectively) and coronary heart disease (1.15 and 1.28, respectively), but not with an increased risk of stroke and all cause mortality.Conclusions Prediabetes, defined as impaired glucose tolerance, impaired fasting glucose, or raised HbA1c, was associated with an increased risk of cardiovascular disease. The health risk might be increased in people with a fasting glucose concentration as low as 5.6 mmol/L or HbA1c of 39 mmol/mol.

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Shift work and risk of stroke: A meta-analysis

Cited by 32 publications

References 23 publications

Shift work and long work hours and their association with chronic health conditions: A systematic review of systematic reviews with meta-analyses

Shift work and long work hours and their association with chronic health conditions: A systematic review of systematic reviews with meta-analyses

Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis

Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis

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