Shift work and hypertension: Prevalence and analysis of disease pathways in a German car manufacturing company.

ABSTRACT

BACKGROUND: Hypertension and cardiovascular disease (CVD) may share a similar pathophysiology. Despite shift workers' CVD excess risk, studies on shift work and hypertension are inconclusive. METHODS: Blood pressure and shift status for 25,343 autoworkers were obtained from medical check-ups and company registers. Cross-sectional associations modeling the total effect from shift work (day shifts, shift work without nights, rotating shift work with nights, and night shifts) on hypertension were assessed. By sequential adjustments, the influence of behavioral, psychosocial, and physiological factors on the total effect was examined, with subsequent mediation and moderation analyses. RESULTS: Adjusted for confounders, shift work without nights (vs. day shifts) was significantly associated with hypertension (OR 1.15, 95%CI 1.02-1.30). The total effect was mediated by BMI, physical inactivity, and sleep disorders. No moderation of the total effect by behaviors was found. CONCLUSION: The association between shift work and hypertension seems mainly attributable to behavioral mechanisms.