Eujin Min Houng Choy, Cassandra Ting, Ginna Alexandra Polania-Zuleta, Impact of Shift Work on Heart Health: Do Shift-Working Healthcare Workers Have Higher Cardiovascular Risk Than Non-Shift Healthcare Workers? A Narrative Review, Journal of Hypertension and Cardiology, Volume 3, Issue 4, 2026, Pages 50-61, ISSN 2329-9487, https://doi.org/10.14302/issn.2329-9487.jhc-26-6071.
(https://openaccesspub.org/hypertension-and-cardiology/article/impact-of-shift-work-on-heart-health-do-shift-working-healthcare-workers-have-higher-cardiovascular-risk-than-non-shift-healthcare-workers-a-2402)
Abstract: Background: Shift work is unavoidable in continuous healthcare delivery, but whether shift-working healthcare staff carry greater cardiovascular risk than their non-shift colleagues has not been synthesised endpoint by endpoint. Objective: To examine, for each cardiovascular risk factor and each clinical cardiovascular complication in turn, whether healthcare workers on shift schedules differ from healthcare workers on day schedules, and to state the strength of evidence supporting each answer. Findings: The answer differs by endpoint. Among complications, shift-working staff show higher ischaemic heart disease incidence when night exposure is sustained (permanent night versus permanent day work: hazard ratio [HR] 1.61, 95% CI 1.06–2.43), higher cerebrovascular disease incidence with frequent nights (HR 1.69, 95% CI 1.18–2.42) and higher cardiovascular mortality (HR 1.71, 95% CI 1.09–2.69), whereas atrial fibrillation shows no difference (HR 0.78, 95% CI 0.49–1.23; 281 cases). Among risk factors, differences are consistent for adiposity (high waist circumference odds ratio [OR] 1.27, 95% CI 1.07–1.51), largely absent for lipids, and not demonstrated for hypertension in the single healthcare comparison available (HR 0.96, 0.75–1.23 across 875 incident cases, precise enough to exclude a modest excess). Type 2 diabetes, occupying an intermediate position, shows the most reproducible difference (HR 1.59, 95% CI 1.02–2.43 for permanent night work; HR 1.05 rising to 1.58 across two decades). Cross-industry appraisal rates certainty low for ischaemic heart disease and very low for hypertension and metabolic outcomes. Conclusion: Shift-working healthcare staff do carry higher cardiovascular risk than non-shift colleagues, but selectively rather than globally, and the excess attaches to sustained night exposure rather than to shift work as a category. Occupational surveillance is best directed at type 2 diabetes and waist circumference; screening for hypertension on this basis is not supported.
Keywords: shift work; night work; cardiovascular risk; healthcare workers; nurses; type 2 diabetes; circadian misalignment; occupational health