Long-term night shift work is associated with the risk of atrial fibrillation and coronary heart disease

Author:

Wang Ningjian1ORCID,Sun Ying1,Zhang Haojie1,Wang Bin1,Chen Chi1ORCID,Wang Yuying1,Chen Jie2,Tan Xiao34ORCID,Zhang Jihui5ORCID,Xia Fangzhen1,Qi Lu678ORCID,Lu Yingli1ORCID

Affiliation:

1. Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China

2. Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, 33 A Kung Kok Street, Sha Tin District, Hong Kong SAR 000000, China

3. Department of Neuroscience, Uppsala University, BMC, 3 Husargatan, Uppsala 75124, Sweden

4. Department of Clinical Neuroscience, Karolinska Institutet, Nobels vag 9, 17165, Stockholm, Sweden

5. Guangdong Mental Health Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 123 Huifu West Road, Yuexiu District, Guangzhou 510000, China

6. Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 1724, New Orleans, LA 70112, USA

7. Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA

8. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA

Abstract

Abstract Aims The aim of this study was to test whether current and past night shift work was associated with incident atrial fibrillation (AF) and whether this association was modified by genetic vulnerability. Its associations with coronary heart disease (CHD), stroke, and heart failure (HF) were measured as a secondary aim. Methods and results This cohort study included 283 657 participants in paid employment or self-employed without AF and 276 009 participants free of CHD, stroke, and HF at baseline in the UK Biobank. Current and lifetime night shift work information was obtained. Cox proportional hazard models were used. Weighted genetic risk score for AF was calculated. During a median follow-up of 10.4 years, 5777 incident AF cases were documented. From ‘day workers’, ‘shift but never/rarely night shifts’, and ‘some night shifts’ to ‘usual/permanent night shifts’, there was a significant increasing trend in the risk of incident AF (P for trend 0.013). Usual or permanent night shifts were associated with the highest risk [hazard ratio (HR) 1.16, 95% confidence interval (CI) 1.02–1.32]. Considering a person’s lifetime work schedule and compared with shift workers never working nights, participants with a duration over 10 years and an average 3–8 nights/month frequency of night shift work exposure possessed higher AF risk (HR 1.18, 95% CI 0.99–1.40 and HR 1.22, 95% CI 1.02–1.45, respectively). These associations between current and lifetime night shifts and AF were not modified by genetic predisposition to AF. Usual/permanent current night shifts, ≥10 years and 3–8 nights/month of lifetime night shifts were significantly associated with a higher risk of incident CHD (HR 1.22, 95% CI 1.11–1.35, HR 1.37, 95% CI 1.20–1.58 and HR 1.35, 95% CI 1.18–1.55, respectively). These associations in stroke and HF were not significant. Conclusion Both current and lifetime night shift exposures were associated with increased AF risk, regardless of genetic AF risk. Night shift exposure also increased the risk of CHD but not stroke or HF. Whether decreasing night shift work frequency and duration might represent another avenue to improve heart health during working life and beyond warrants further study.

Funder

Science and Technology Commission of Shanghai Municipality

Shanghai Municipal Human Resources and Social Security Bureau

Clinical Research Plan of Shanghai Hospital Development Center

National Natural Science Foundation of China

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

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