Manohar Sandhya, Thongprayoon Charat, Cheungpasitporn Wisit, Mao Michael A, Herrmann Sandra M
aDivision of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota bDepartment of Internal Medicine, Bassett Medical Center, Cooperstown, New York, USA.
J Hypertens. 2017 Oct;35(10):1929-1937. doi: 10.1097/HJH.0000000000001442.
The reported risks of hypertension (HTN) in rotating shift and night shift workers are controversial. The objective of this meta-analysis was to assess the association between shift work status and HTN.
A literature search was performed using MEDLINE, EMBASE and Cochrane Database from inception through October 2016. Studies that reported odds ratios (OR) comparing the risk of HTN in shift workers were included. A prespecified subgroup analysis by rotating shift and night shift statuses were also performed. Pooled OR and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. The protocol for this study is registered with International Prospective Register of Systematic Reviews; no. CRD42016051843.
Twenty-seven observational studies (nine cohort and 18 cross-sectional studies) with a total of 394 793 individuals were enrolled. The pooled ORs of HTN in shift workers in cohort and cross-sectional studies were 1.31 (95% CI, 1.07-1.60) and 1.10 (95% CI, 1.00-1.20), respectively. When meta-analysis was restricted only to cohort studies in rotating shift, the pooled OR of HTN in rotating shift workers was 1.34 (95% CI, 1.08-1.67). The data regarding night shift and HTN in cohort studies was limited. The pooled OR of HTN in night shift workers in cross-sectional studies was 1.07 (95% CI, 0.85-1.35).
Based on the findings of our meta-analysis, shiftwork status may play an important role in HTN, as there is a significant association between rotating shift work and HTN. However, there is no significant association between night shift status and risk of HTN.
轮班和夜班工作者患高血压（HTN）的风险报道存在争议。本荟萃分析的目的是评估轮班工作状态与高血压之间的关联。
使用MEDLINE、EMBASE和Cochrane数据库从建库至2016年10月进行文献检索。纳入报告了比较轮班工作者患高血压风险的比值比（OR）的研究。还按轮班和夜班状态进行了预先设定的亚组分析。采用随机效应、通用逆方差法计算合并OR和95%置信区间（CI）。本研究方案已在国际前瞻性系统评价注册库注册；注册号为CRD42016051843。
纳入了27项观察性研究（9项队列研究和18项横断面研究），共394793人。队列研究和横断面研究中轮班工作者患高血压的合并OR分别为1.31（95%CI，1.07 - 1.60）和1.10（95%CI，1.00 - 1.20）。当荟萃分析仅局限于轮班工作的队列研究时，轮班工作者患高血压的合并OR为1.34（95%CI，1.08 - 1.67）。队列研究中关于夜班与高血压的数据有限。横断面研究中夜班工作者患高血压的合并OR为1.07（95%CI，0.85 - 1.35）。
基于我们荟萃分析的结果，轮班工作状态可能在高血压中起重要作用，因为轮班工作与高血压之间存在显著关联。然而，夜班状态与高血压风险之间无显著关联。
