Dataset Information

The combined effect of long working hours and individual risk factors on cardiovascular disease: An interaction analysis.

ABSTRACT:

Objectives

We examined whether the effect of long working hours on the risk of developing cardiovascular disease (CVD) differs depending on individual risk factors.

Methods

Seven-year follow-up data were extracted from the 2009 to 2016 waves of the Korea Health Panel Survey. Physician's diagnosis or medication for hypertension, diabetes, dyslipidemia, and obesity were included as chronic disease status. Smoking, drinking alcohol, and exercise levels were considered as lifestyle behavior. Hazard ratios were calculated using the Cox regression models to evaluate the risk of CVD related to chronic diseases and unhealthy behavior, based on working hour groups, after adjusting for other covariates. The interactive effects of long working hours with or without chronic diseases and unhealthy behavior on CVD were assessed using the relative excess risk due to interaction and attributable proportion measures.

Results

There was a statistically significant interaction between long working hours and chronic diseases within the population, especially among male participants (P-value for interaction <.01 and .03, respectively). There were no significant interactions between unhealthy behavior and long working hours.

Conclusions

Long working hours and chronic disease have a synergistic negative effect on the risk of CVD.

SUBMITTER: Lee W

PROVIDER: S-EPMC7870363 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

The combined effect of long working hours and individual risk factors on cardiovascular disease: An interaction analysis.

Lee Wanhyung W Lee Jongin J Kim Hyoung-Ryoul HR Lee Yu Min YM Lee Dong-Wook DW Kang Mo-Yeol MY

Journal of occupational health 20210101 1

<h4>Objectives</h4>We examined whether the effect of long working hours on the risk of developing cardiovascular disease (CVD) differs depending on individual risk factors.<h4>Methods</h4>Seven-year follow-up data were extracted from the 2009 to 2016 waves of the Korea Health Panel Survey. Physician's diagnosis or medication for hypertension, diabetes, dyslipidemia, and obesity were included as chronic disease status. Smoking, drinking alcohol, and exercise levels were considered as lifestyle be ...[more]

PMID: 33556993

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Project description:BackgroundObservational studies suggest that early menopause is associated with increased risk of death and cardiovascular disease (CVD); however, the results of these studies have been inconsistently. We aimed to assess the association of menopause with death and CVD and whether this association was modified by cardiovascular risk factors.MethodsThe study population was women age 35-64 years living in two communities of Beijing who were enrolled in the Chinese Multi-provincial Cohort Study in 1992. Participants were followed until first cardiovascular event, death, or the end of follow-up (2018). Self-reported age at menopause was recorded. Multivariate Cox regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of death and CVD after adjusting for baseline covariates of age, family history of CVD, and white blood cell count, as well as time-varying covariates of menopause, use of oral estrogen, and conventional risk factors. Additionally, we assessed the combined effect of age at menopause and risk factors on the primary endpoint.ResultsOf 2104 eligible women, 124 died and 196 had a first CVD event (33 fatal CVD and 163 non-fatal CVD). Compared with women who experienced menopause at age 50-51 years, the risk of death was higher in women with menopause at age 45-49 years (HR 1.99, 95% CI 1.24-3.21; P = 0.005), and the risk of ischemic stroke was higher in women with menopause at age < 45 years (HR 2.16, 95% CI 1.04-4.51; P = 0.04) and at age 45-49 years (HR 2.05, 95% CI 1.15-3.63; P = 0.01). Women who had menopause before age 50 years and at least one elevated risk factor at baseline had a higher risk of death (HR 11.10, 95% CI 1.51-81.41; P = 0.02), CVD (HR 3.98, 95% CI 1.58-10.01; P = 0.003), ischemic CVD (HR 4.53, 95% CI 1.63-12.62; P = 0.004), coronary heart disease (HR 8.63, 95% CI 1.15-64.50; P = 0.04), and stroke (HR 2.92, 95% CI 1.03-8.29; P = 0.04) than those with menopause at age 50-51 years and optimal levels of all risk factors.ConclusionsEarlier menopause may predict death and ischemic stroke. Furthermore, there is a combined effect of earlier menopause and elevated risk factors on death and CVD.

Project description:ObjectiveTo quantify the association between long working hours and alcohol use.DesignSystematic review and meta-analysis of published studies and unpublished individual participant data.Data sourcesA systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies.Review methodsThe search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression.ResultsCross sectional analysis was based on 61 studies representing 333,693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100,602 participants from nine countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1.20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours and ≥ 55 hours a week were 1.13 (1.02 to 1.26; adjusted difference in incidence 0.8 percentage points) and 1.12 (1.01 to 1.25; adjusted difference in incidence 0.7 percentage points), respectively, compared with working standard 35-40 hours (incidence of new onset risky alcohol use 6.2%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate.ConclusionsIndividuals whose working hours exceed standard recommendations are more likely to increase their alcohol use to levels that pose a health risk.

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Dataset Information

The combined effect of long working hours and individual risk factors on cardiovascular disease: An interaction analysis.

Objectives

Methods

Results

Conclusions

Publications

The combined effect of long working hours and individual risk factors on cardiovascular disease: An interaction analysis.

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