| Summary: | 博士 === 國立臺灣大學 === 職業醫學與工業衛生研究所 === 96 === Dynamic Blood Pressure, Heart rate Variability Changes and Recovery under Different Work Shifts
Background To explore the effect of shift work on cardiac stress, we studied the heart rate variability (HRV) profiles and blood pressure (BP) change in young female nurses.
Methods We recruited 16 young female nurses working rotating shifts and 6 working the regular day shift and gave each of them simultaneous and repeated 48-hour ambulatory electrocardiography and BP monitoring during their workdays and the following off-duty day.
Results Using a linear mixed effect model, we found increased vagal autonomic control during sleep and on a night or an evening shift, and a decreased vagal autonomic control and increased BP at work, during sleep after a night or evening shift, and on the work day of a night shift. Cardiac sympathetic modulation showed reciprocal changes in the corresponding conditions (all P<.005). Blood pressure (BP) appeared to synchronize with the increased cardiac sympathetic modulation and decreased vagal modulation. The recovery of HRV and BP on the following off-duty day appeared incomplete after adjustment for other risk factors. The rates of change in dipper/nondipper status between work day and off-duty day were 33%, 44%, 50%, and 38% for nurses worked in outpatient clinic, night shift, evening shift, and day shift, respectively. We also found 69% of those working rotating shifts had at least changed once in dipper/nondipper status.
Conclusion The effects of rotating shifts on HRV and BP in young female nurses are significant not only at work but also on the day of a night shift, during sleep on days of a night shift or an evening shift, and the entire work day of a night shift. Shift work is significantly associated with BP and HRV and possibly dipper/nondipper status in young female nurses. We recommend that potential influence of shift work be considered when evaluating a person’s blood pressure. The residual effect of night shifts may carry over to the next off-duty day.
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