Abstract
AimsStudies suggest that people who work long hours are at increased risk of stroke, but the association of long working hours with atrial fibrillation, the most common cardiac arrhythmia and a risk factor for stroke, is unknown. We examined the risk of atrial fibrillation in individuals working long hours (≥55 per week) and those working standard 35–40 h/week.Methods and resultsIn this prospective multi-cohort study from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium, the study population was 85 494 working men and women (mean age 43.4 years) with no recorded atrial fibrillation. Working hours were assessed at study baseline (1991–2004). Mean follow-up for incident atrial fibrillation was 10 years and cases were defined using data on electrocardiograms, hospital records, drug reimbursement registers, and death certificates. We identified 1061 new cases of atrial fibrillation (10-year cumulative incidence 12.4 per 1000). After adjustment for age, sex and socioeconomic status, individuals working long hours had a 1.4-fold increased risk of atrial fibrillation compared with those working standard hours (hazard ratio = 1.42, 95% CI = 1.13–1.80, P = 0.003). There was no significant heterogeneity between the cohort-specific effect estimates (I2 = 0%, P = 0.66) and the finding remained after excluding participants with coronary heart disease or stroke at baseline or during the follow-up (N = 2006, hazard ratio = 1.36, 95% CI = 1.05–1.76, P = 0.0180). Adjustment for potential confounding factors, such as obesity, risky alcohol use and high blood pressure, had little impact on this association.ConclusionIndividuals who worked long hours were more likely to develop atrial fibrillation than those working standard hours.
Highlights
The 2016 European Guidelines for cardiovascular disease prevention acknowledges psychosocial stress at work as a potential risk factor for cardiovascular disease,[9] citing evidence that show long working hours to be associated with increased stroke risk,[10] little is known about the role of long working hours as a potential risk factor of atrial fibrillation
During the mean follow-up of 10.0 years, 1061 participants were diagnosed with atrial fibrillation (10-year cumulative incidence 12.4 per 1000)
In 71.4% of cases, atrial fibrillation was diagnosed before the age of 65 (see line were excluded (n = 250)
Summary
The 2016 European Guidelines for cardiovascular disease prevention acknowledges psychosocial stress at work as a potential risk factor for cardiovascular disease,[9] citing evidence that show long working hours to be associated with increased stroke risk,[10] little is known about the role of long working hours as a potential risk factor of atrial fibrillation. We conducted a large-scale study on long working hours and incident atrial fibrillation in the general population using data from cohort studies participating in the IndividualParticipant-Data Meta-analysis in Working Populations (IPD-Work) Consortium.[10,17,18]
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