Shift Work Tied to Higher Risk of Incident and Fatal CVD

Pavankumar Kamat


September 08, 2021


  • Shift workers had a higher risk of incident and fatal cardiovascular disease (CVD), which was partly mediated through modifiable risk factors such as smoking, sleep duration and quality, adiposity and metabolic status.

Why this matters

  • Findings highlight the need to better manage CVD risk among shift workers through lifestyle interventions, such as smoking cessation and weight management, which could be delivered within workplace settings to individuals who are at the most risk.

Study design

  • Researchers at the University of Glasgow conducted a prospective cohort study of 238,661 participants who were in paid employment or self-employed, identified from the UK Biobank.

  • Funding: None.

Key results

  • Shift workers vs non-shift workers had an increased risk of (adjusted HR [aHR]; 95% CI):

    • incident CVD (1.11; 1.06-1.16; P<.0001); and

    • fatal CVD (1.25; 1.08-1.44; P=.002).

  • Compared with men and work involving more heavy manual labour, longer duration of shift work was more strongly associated with incident CVD in (aHR; 95% CI):

    • women (1.16; 1.07-1.27; P=.005); and

    • work involving minimal heavy manual labour (1.18; 1.10-1.27; P=.002).

  • The association of shift work with heart failure (aHR, 1.15; 95% CI, 1.03-1.28) was stronger than that with stroke (aHR, 1.09; 95% CI, 0.99-1.20) and ischaemic heart disease (aHR, 1.09; 95% CI, 1.03-1.15).

  • Current smoking (14.1%), sleep (12.3%), adiposity (9.8%), higher glycated haemoglobin level (10.7%) and cystatin C (5.5%) were the key potentially modifiable mediators for CVD.


  • UK Biobank is not representative of the entire general population in terms of lifestyle.


Ho FK, Celis-Morales C, Gray SR, Demou E, Mackay D, Welsh P, Katikireddi SV, Sattar N, Pell JP. Association and pathways between shift work and cardiovascular disease: a prospective cohort study of 238 661 participants from UK Biobank. Int J Epidemiol. 2021 Aug 20 [Epub ahead of print]. doi: 10.1093/ije/dyab144. PMID: 34414428.  View abstract 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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