Associations Between Sleep Quality and 10-Year Cardiovascular Disease Risk Among Female Nurses in Hong Kong: A Cross-sectional Study

Cardiovascular risk factors among nurses: A global systematic review and meta-analysis

BACKGROUND

Nurses as the largest group of health workers have a very stressful job which can cause number of diseases specially increase cardiovascular risk factors. This study aims to investigate the overall epidemiology of cardiovascular disease (CVD) risk factors among nurses.

METHOD

We searched all four main databases such as Scopus, PubMed, Embase and Web of Sciences from the beginning of 2000 to March 2022 with appropriate Mesh Terms. We also searched Google scholar. Then we applied inclusion and exclusion criteria and after selection the studies the Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of included studies. Comprehensive Meta-analysis and R software was used for analysis.

RESULTS

Finally, 22 articles with a total number of 117922 nurses were included. Among all risk factors, sedentary lifestyle and lack of regular physical activity with a prevalence of 46.3% (CI 95%, 26.6-67.2) was regarded as the main prevalent risk factor among nurses. The mean systolic blood pressure (SBP) measured in the study population was 121.31 (CI 95%, 114.73-127.90) and the mean diastolic blood pressure (DBP) was 78.08 (CI 95%, 74.90-81.25). Also family history of cardiovascular disease (41.9%; 95% IC: 29.8-55.1%), being overweight (33.3%; 95% IC: 24.7-43.2%), and alcohol consumption (24.6%; 95% IC: 16.4-35.2%) was found among the participants.

CONCLUSION

Study results revealed that sedentary lifestyle was the main prevalent CVD risk factor among nurses followed by family history of cardiovascular disease, being overweight and alcohol consumption. Furthermore, among nurses with shift works almost all risk factors got higher score representing the worse condition in comparison with day workers' nurses. This study enables learning the associated risk factors of CVD among nurses to facilitate interventional programs with a view to reduce the exposure of nursing staff particularly those who work in shifts to cardiovascular risk factors.

1. WHAT WAS ALREADY KNOWN?

In general, many studies have emphasized the impact of the nursing profession on the incidence of some cardiovascular patients. Also, different shifts of nurses can have a double effect.

2. WHAT ARE THE NEW FINDINGS?

In this study, the mean for sedentary lifestyle was reported to be 46.3% which represented the most prevalent risk factor for cardiovascular risk factors among study population.

3. WHAT IS THEIR SIGNIFICANCE?

This study enables learning the associated risk factors of CVD among nurses to facilitate interventional programs with a view to reduce the exposure of nursing staff particularly those who work in shifts to cardiovascular risk factors. This information can comprise essential tools for health human resource management contributing to advance nursing.

Sleep Behaviors and Progression of Multimorbidity in Middle-Aged and Older Adults: A Prospective Cohort Study From China

BACKGROUND

Sleep behavior (eg, sleep duration, sleep quality, and nap) is closely related to many chronic conditions. However, less is known about its association with multiple chronic conditions (multimorbidity), particularly evidence from cohort studies.

METHODS

Data were collected from a cohort of 8 937 individuals aged 45 and older from the China Health and Retirement Longitudinal Study (2011-2018). Sleep duration, sleep quality, and nap duration were collected in 2011 and 2013. Progression of multimorbidity was defined as the first report of 2 or more chronic conditions for participants without multimorbidity or the new report of 1 or more conditions for those with multimorbidity. Cox regression models were performed to calculate the hazard ratios and 95% confidence intervals (CIs) of the associations between sleep behaviors and the progression of multimorbidity.

RESULTS

Short sleep duration and poor sleep quality were associated with the progression of multimorbidity independently and jointly, especially in those less than 65 years and females. The U-shaped dose-response relationships were observed between nighttime and total sleep duration and the progression of multimorbidity. Persistent short and unsteadily changed sleep behaviors increased the risk of multimorbidity progression. Individuals sleeping ≤5 h/night with 5-7 restless days/week had 1.53 times higher risk of multimorbidity progression (95% CI: 1.37-1.71), compared to those sleeping 7-8 h/night with <1 restless day/week.

CONCLUSIONS

Short sleep duration and poor sleep quality were independently and jointly associated with a higher risk of multimorbidity progression in a mid-to-older population. Optimal sleep duration and sleep quality should be emphasized in multimorbidity prevention and control.

The Role of Dietary Inflammatory Index on the Association Between Sleep Quality and Long-Term Cardiovascular Risk: A Mediation Analysis Based on NHANES (2005-2008)

OBJECTIVE

People with poor sleep quality have higher risk of cardiovascular disease (CVD), and one potential mechanism of CVD is chronic inflammation. The aim of this study was to investigate the role of dietary inflammation in the relationship between sleep quality and CVD risk.

METHODS

This study involved 5594 participants from the National Health and Nutrition Examination Survey (NHANES) in 2005-2008. Sleep quality, dietary inflammation, and 10-year CVD risk were evaluated via the Pittsburgh Sleep Quality Index (PSQI), the Energy-adjusted Dietary Inflammatory Index (E-DII), and the Framingham Risk Score (FRS), respectively. We used generalized additive model (GAM) and mediation analysis to investigate the relationship among sleep quality, 10-year CVD risk, and E-DII.

RESULTS

PSQI had a non-linear relationship with 10-year CVD risk (P < 0.001). Meanwhile, among the participants with poor sleep quality, PSQI was positively associated with increased 10-year CVD risk (P < 0.001) and E-DII (P < 0.001). Furthermore, the association between sleep quality and CVD risk was partially mediated by E-DII, and the mediated proportion was 14.6%, and the mediating effect of E-DII varied in different gender and age groups. However, in the subjects with good sleep quality, the association among PSQI, E-DII, and 10-year CVD risk was not existed.

CONCLUSION

Ten-year CVD risk could be reduced by controlling the intake of inflammatory food, especially for whom with sleep disorders. In general, the reduction of inflammatory diet could weaken the effect of sleep disorders on the CVD risk.