Year of Publication



Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Kathleen Winter, PhD, MPH

Committee Member

Olga Vsevolozhskaya, PhD

Committee Member

Steven Fleming, PhD


Purpose: Individuals working non-daytime shifts have been reported to have an increased risk for many negative health outcomes, including poor cardiovascular health. This study aims to examine the relationship between shift worked and hypertension—a major risk factor for cardiovascular disease. Of particular interest in this study was the role of stress and type of shift worked (day, evening, night, or rotating) in this relationship.

Methods: The study utilized National Health and Nutrition Examination Survey data collected between 2005 and 2010. The study population was limited to adult workers 20 years of age and older (n=9356). Initial descriptive statistics of demographic characteristics and stress measurements were obtained. Analyses were stratified by smoking status. The adjusted odds ratios (ORs) were obtained for each relevant risk factor, followed by final multivariate model selection for each smoking and non-smoking populations.

Results: In the non-smoking model only known risk factors gave significantly higher odds of hypertension when adjusting for other covariates in the model. Sleeping more hours per night (OR 0.92, 95% confidence interval (CI) 0.87, 0.98) and working night shift (OR 0.57, CI=0.34, 0.95) had statistically significant protective effects in non-smokers. Among smokers, a statistically significant interaction between age and night shift work was found (OR 1.05, 95% CI=1.02, 1.08).

Conclusions: Shift worked and stress may be significant factors in the development of hypertension, though the relationship is complex. Sleep may play an important protective role against hypertension. Additionally, smoking night shift workers may be at an increased risk for hypertension with increasing age.

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