Impact of one year of shift work on cardiovascular disease risk factors

The purpose of the study was to investigate whether the reported increased cardiovascular disease risk in shift workers could be explained by changes in cardiovascular risk factors. In a cohort of 239 shift and 157 daytime workers, 1-year changes in biological and lifestyle cardiovascular risk factors were monitored between the start of a new job and 1 year later. Both body mass index and low-density lipoprotein/high-density lipoprotein cholesterol ratio decreased significantly in shift workers compared with daytime workers (body mass index change: -0.31 and +0.13 kg/m; low-density lipoprotein/high-density lipoprotein ratio change: -0.33 and -0.13 respectively). Cigarettes smoked per day increased significantly in shift compared with daytime workers (+1.42 and -1.03, respectively). Therefore, only for smoking, an unfavorable change was observed. This may explain, at most, only a part of the excess cardiovascular disease risk reported in shift workers.     

Effects of exercise on emerging and traditional cardiovascular risk factors

BACKGROUND: Common cardiovascular disease risk factors (e.g., insulin and aerobic fitness) are improved with exercise; however, few studies have addressed the potential for training to modify emerging cardiovascular disease risk factors such as homocysteine and high-sensitivity C-reactive protein. METHODS: Sedentary adults (n = 324, 48.9 +/- 8.4 years) were randomized to four groups differing in training intensity (moderate = 45-55% or high = 65-75% of heart rate reserve) and frequency (low = 3-4, 30-min sessions/week or high = 5-7, 30 min-sessions/week). RESULTS: Within-group changes in homocysteine, insulin, and aerobic fitness were significant (all P < 0.0125). Furthermore, homocysteine increased in the high-intensity-low-frequency (0.98 +/- 2.32 micromol/L) and high-intensity-high-frequency (0.93 +/- 2.56 micromol/L) groups, while aerobic fitness increased in the moderate-intensity-high-frequency (0.99 +/- 2.01 mL min(-1) kg(-1)) and high-intensity-high-frequency (1.77 +/- 2.97 mL min(-1) kg(-1)) groups (all P < 0.003). The change in aerobic fitness was greater in the high-intensity-high-frequency compared to the moderate-intensity-low-frequency group (1.77 +/- 2.97 vs. 0.36 +/- 2.10 mL min(-1) kg(-1), P = 0.0014) (effect size estimate = 0.60 mL min(-1) kg(-1)). The main effects for intensity, with respect to the change in insulin (effect size estimate = 0.46 microU/mL), and frequency, with respect to the change in aerobic fitness (effect size estimate = 0.38 mL min(-1) kg(-1)), were significant (P < 0.0125). CONCLUSION: Although frequent bouts of higher intensity exercise were particularly effective in reducing fasting insulin and improving fitness, they resulted in slightly increased homocysteine levels.     

Association between shift rotation and 30-year Framingham risk of cardiovascular disease among male workers in a medium-sized manufacturing factory

Rotating shift work is associated with an increased risk of cardiovascular disease (CVD). This study compared the CVD risk score in 129 male line workers aged 22–49 years on different shifts in a medium-sized metal production factory from 2017 to 2020. We classified workers into four groups: permanent day shift, weekly rotation involving five consecutive nights, weekly rotation involving 3–4 consecutive nights, and monthly rotation involving two consecutive nights. We used the Framingham Risk Score to estimate the 30-yr risks of general and hard CVD (CVD risk estimates). We investigated the differences in CVD risk estimates between different groups using linear mixed models. The average 30-yr Framingham CVD risk estimates of each group ranged from 17.5% to 31.2% for general CVD and from 10.5% to 20.5% for hard CVD. Workers on weekly rotations involving 3–5 consecutive nights had 5%–10% significantly higher CVD risk estimates than workers on the permanent day shift. Workers on weekly rotations also had 6%–8% higher BMI-based CVD risk estimates than those on the monthly rotation involving two consecutive nights. While 24-h shift rotations are unavoidable, our findings underscored the potential CVD risk among workers on weekly rotations involving more consecutive nights.     

Effects of cocoa flavanols on risk factors for cardiovascular disease

Epidemiologic investigations support the hypothesis that regular consumption of flavonoid-containing foods can reduce the risk of cardiovascular diseases (CVD). While flavonoids are ubiquitous in plants, cocoa can be particularly rich in a sub-class of flavonoids known as flavanols. A number of human dietary intervention trials with flavanol-containing cocoa products have demonstrated improvements in endothelial and platelet function, as well as blood pressure. These studies provide direct evidence for the potential cardiovascular benefits of flavanol-containing foods and help to substantiate the epidemiological data. In this review, results from selective published trials with cocoa and chocolate focused on risk for CVD will be discussed along with a study we recently completed evaluating the effects of the daily consumption of flavanol-containing dark chocolate (CocoaVia?) with and without plant sterol esters on CVD markers in a normotensive population with mild hypercholesterolemia. In this study, the daily consumption of flavanol-containing dark chocolate was associated with a significant mean reduction of 5.8 mmHg in systolic blood pressure. Together the results of these human dietary intervention trials provide scientific evidence of the vascular effects of cocoa flavanols and suggest that the regular consumption of cocoa products containing flavanols may reduce risk of CVD.     

Effects of cardiovascular risk factors on hemorheologic parameters in cerebrovascular patients

INTRODUCTION: Hemorheological factors are of significance in the determination of flow characteristics of blood and play an important role in the pathogenesis of cerebrovascular diseases. AIMS AND METHODS: In this study the changes of rheological factors--hematocrit (Hct), plasma fibrinogen concentration (PFC), whole blood (WBV) and plasma viscosity (PV), red blood cell aggregation (AI) and deformability and the association between these parameters and cardiovascular risk factors were investigated in 297 patients (173 males, 124 females, mean age: 60 11 years) with chronic phase (3 months after onset) ischemic cerebrovascular diseases, and in 68 healthy volunteers (30 males, 38 females, mean age: 36 6 years). RESULTS: All investigated hemorheological factors were significantly (p < 0.05-0.0001) elevated in cerebrovascular patients compared to normal controls, the rise in Hct, WBV and PV are some of the most prominent findings. In the group of hypertensive, hyperlipidemic patients, smokers and alcoholics Hct, PFC, WBV, PV and AI were significantly (p < 0.05-0.0001) higher compared to healthy controls, the same factors except plasma fibrinogen concentration showed association with diabetic history. Comparing cerebrovascular patients with or without risk factors, the most severe hemorheological deficit was observed in patients with hyperlipidemia and smoking habits. CONCLUSIONS: In this study the authors proved in chronic ischemic cerebrovascular patients that hemorheological abnormalities persist in most cases for a long time after an acute stroke, significant correlation could be seen between blood rheology and cardiovascular risk factors. Examination of rheological parameters can support to choose the optimal medical treatment in the secondary prevention of stroke, correction of hemorheological disturbances can reduce the risk of recurrent stroke.     

Effects of cold air on cardiovascular disease risk factors in rat

The purpose of this study is to explore possible potential implications of cold air in cardiovascular disease (CVD) risk in rats. Healthy Wistar rats were exposed to artificial cold air under laboratory conditions, and their systolic blood pressure, heart rate, vasoconstriction, CVD risk factors, and myocardial damage indicators after cold air exposure were determined and evaluated. Systolic blood pressure, whole blood viscosity, and plasma level of norepinephrine, angiotensinⅡ, low density lipoprotein, total cholesterol, and fibrinogen in treatment groups increased significantly compared with control groups. No significant variations were found in plasma Mb and cTnT and myocardial tissue between the treatment and control groups. Results indicate that: (1) higher levels of SBP, WBV and LDL/HDL, total cholesterol (TC), and FG in blood may indicate higher CVD risks during cold air exposure; (2) cold air may exert continuous impacts on SBP and other CVD risk factors.     

血脂异常人群中体质指数变化对心血管病危险因素的影响

目的 探讨纵向队列中血脂异常患者BMI变化对心血管病危险因素的影响。方法 基于赣州市2017—2020年慢性病队列,随访四年,计算2017—2020年受试者BMI、血压、血脂（TG、TC、LDL、HDL）、空腹血糖和糖化血红蛋白水平变化值。剔除基线高血压、糖尿病和血脂正常参与者,共随访724人。采用Cox比例风险回归分析不同BMI变化与心血管病危险因素的关联。结果 2017年超重肥胖患者329例（45.4%）,持续异常组血压增幅高于持续正常组（收缩压：H=19.888,P<0.001;舒张压：H=8.149,P=0.043）,转归异常组TG增幅高于持续正常组（H=12.161,P<0.05）。持续异常组高血压发病风险、TG不达标比例、HDL不达标比例分别是持续正常组的2.57(1.70～3.88)倍、1.47(1.15～1.89)倍、2.59(1.34～5.00)倍。转归异常组对心血管病危险因素的影响与持续异常组相似,此外,转归异常组增加了T2DM的发病风险（HR=3.79,95%CI:1.06～13.47）,与持续正常组相比逆转正常组对高血压和糖尿病发病风险以及血脂未达标...     

Effects of pistachios on cardiovascular disease risk factors and potential mechanisms of action: a dose-response study

BACKGROUND: Nut consumption lowers cardiovascular disease (CVD) risk. Studies are lacking about the effects of pistachios, a nutrient-dense nut, on CVD risk factors, dose-response relations, and lipid-lowering mechanisms. OBJECTIVE: We evaluated the effects of 2 doses of pistachios, added to a lower-fat diet, on lipids and lipoproteins, apolipoprotein (apo)-defined lipoprotein subclasses, and plasma fatty acids. To investigate the mechanisms of action, we measured cholesteryl ester transfer protein and indexes of plasma stearoyl-CoA desaturase activity (SCD). DESIGN: In a randomized crossover controlled-feeding study, 28 individuals with LDL cholesterol > or = 2.86 mmol/L consumed 3 isoenergetic diets for 4 wk each. Baseline measures were assessed after 2 wk of a typical Western diet. The experimental diets included a lower-fat control diet with no pistachios [25% total fat; 8% saturated fatty acids (SFAs), 9% monounsaturated fatty acids (MUFAs), and 5% polyunsaturated fatty acids (PUFAs)], 1 serving/d of a pistachio diet (1 PD; 10% of energy from pistachios; 30% total fat; 8% SFAs, 12% MUFAs, and 6% PUFAs), and 2 servings/d of a pistachio diet (2 PD; 20% of energy from pistachios; 34% total fat; 8% SFAs, 15% MUFAs, and 8% PUFAs). RESULTS: The 2 PD decreased (P < 0.05 compared with the control diet) total cholesterol (-8%), LDL cholesterol (-11.6%), non-HDL cholesterol (-11%), apo B (-4%), apo B/apo A-I (-4%), and plasma SCD activity (-1%). The 1 PD and 2 PD, respectively, elicited a dose-dependent lowering (P < 0.05) of total cholesterol/HDL cholesterol (-1% and -8%), LDL cholesterol/HDL cholesterol (-3% and -11%), and non-HDL cholesterol/HDL cholesterol (-2% and -10%). CONCLUSIONS: Inclusion of pistachios in a healthy diet beneficially affects CVD risk factors in a dose-dependent manner, which may reflect effects on SCD.     

Effects of a very-low-calorie diet on metabolic control and cardiovascular risk factors in the treatment of obese non-insulin-dependent diabetics

Ten obese non-insulin-dependent diabetics (six men, four women) with secondary drug failure were treated with a hypocaloric diet only (2100-3350 kJ/d) for 3 mo to assess the effects of weight reduction on metabolic control, energy production rate, and cardiovascular risk factors. During the 3 mo of follow-up the mean body weight decreased from 101.0 +/- 7.2 (means +/- SEM) to 87.2 +/- 5.5 kg (p less than 0.001). Basal energy production rate (kJ/min) decreased by 8.5%. Fasting blood glucose declined from 12.3 +/- 0.4 to 10.5 +/- 0.7 mmol/L (p less than 0.05) but mean diurnal glucose and glycosylated hemoglobin A1c did not change significantly. Serum total cholesterol was decreased at 2 wk but at 3 mo it did not differ significantly from the baseline value. A marked reduction was observed in serum triglycerides after 3 mo (4.57 +/- 1.0 vs 2.18 +/- 0.26 mmol/L, p = 0.012). The high-density lipoprotein (HDL) cholesterol increased after weight reduction (0.96 +/- 0.06 vs 1.11 +/- 0.05 mmol/L, p = 0.009). A significant decline was found in both systolic (152 +/- 6 vs 133 +/- 3 mm Hg, p = 0.004) and diastolic blood pressure (92 +/- 3 vs 81 +/- 3 mm Hg, p = 0.007). There was no evidence of linoleic acid deficiency after this diet.     

Erectile dysfunction and cardiovascular risk factors

Erectile dysfunction (ED) affects as many as 30 million men in the United States. Its risk factors are similar to those for atherosclerotic heart disease. Physicians should ask male patients--particularly those with cardiovascular disease--about ED and men with confirmed ED about cardiovascular risk factors. Oral sildenafil is an effective therapy for both organic and psychogenic ED; it is contraindicated in patients taking organic nitrates.     

Skinfold thickness and cardiovascular risk factors

The relation of blood pressure, serum cholesterol, plasma fibrinogen, and coagulation factor VIIc with skinfold thickness at four sites (forearm, triceps, suprailiac, and subscapular) was examined in 2,948 white participants in the Northwick Park Heart Study. When considered separately, all four skinfolds were significantly associated with the four cardiovascular risk factors in males. Of the two limb skinfolds, forearm was consistently more strongly associated than triceps with the risk factors. The magnitude of the association between forearm skinfold and the risk factors was similar to that of the two trunk skinfolds, suprailiac and subscapular. Multiple regression analysis suggested an independent association of forearm skinfold with cholesterol and blood pressure in males when the other skinfolds were taken into account. There was no consistent difference in the strength of the associations of the two trunk skinfolds with the risk factors. With the exception of systolic blood pressure, the associations between the cardiovascular risk factors and skinfold thickness in males were stronger at younger ages. In the case of females the findings were somewhat different. The associations with the four risk factors were consistently stronger for the two trunk skinfolds than the limb skinfolds. Triceps was somewhat more strongly associated with the risk factors than forearm skinfold except for plasma fibrinogen. Thus there are sex differences in the association of the distribution of subcutaneous fat with cardiovascular risk factors.     

Parent-child obesity and cardiovascular risk factors

Blood pressure, cholesterol, high density lipoprotein cholesterol, and triglycerides were studied in obese children and obese parents selected to participate in a weight treatment program. The relationships between parent and child risk levels, as well as the relationship between child and parent weight and risk factors, were established. Results showed that children's cholesterol and triglycerides were related to parental lipid levels, independent of weight. Children's blood pressure readings were strongly related to their weight, but not to parental blood pressure. High density lipoprotein cholesterol levels were negatively related to weight in both child and parent female populations, and weakly positively related to weight for male children. Implications of these risk factor patterns for intervention are discussed.     

Influence of differences in their jobs on cardiovascular risk factors in male blue-collar shift workers in their fifties

This study examined relationships between different job types of shift work and hypertension, obesity, and dyslipidemia. Male blue-collar workers 50-59 years of age (n = 210) on the same three-shift schedule in a pulp and paper mill were divided into two groups; 118 in paper manufacturing (group 1) and 92 in the chemical products section (group 2). Only the frequency of hypertension differed significantly (p = 0.012) between the groups, 52.2% (n = 48) in group 2 vs 33.9% (n = 40) in group 1. The odds ratio for group 2 in relation to hypertension was 2.3 (95% CI 1.2-4.2). These results indicate a positive association between job type of shift work and hypertension and suggest that different job types of shift workers should not be combined when the effects of shift work on blood pressure are being examined.     

Rescheduling a three shift system at a steel rolling mill: effects of a one hour delay of shift starting times on sleep and alertness in younger and older workers.

OBJECTIVE: To evaluate a new work schedule at a Finnish steel mill with special attention to effects on older workers. The schedule was designed to improve sleep before the morning shift, and alertness during the morning shift, by delaying shift start and end times. METHODS: Evaluation was by a shiftwork health and safety questionnaire, recordings of work-rest-sleep cycles with activity monitors worn on the wrist, daily diaries, and on site computerised testing of fatigue and alertness by the NIOSH fatigue test battery. RESULTS: The one hour delay in shift starting times improved sleep before the morning shift, and improved waking fatigue, sleepiness, and performance during the morning shift. Evening and night shift sleep and fatigue or sleepiness, however, were affected negatively by the new work schedule, but the results for those shifts were less consistent across the various measures. Despite the improvements, most workers were not satisfied with the new schedule because of social concerns. Few interactions of age with the new work schedule were found, suggesting that the effects of the work schedule were uniform across age groups. CONCLUSION: A change of as little as one hour in shift starting times can improve morning shift sleep and alertness, but there are trade offs from these improvements in terms of night shift effects and social considerations. It seems, then, that optimal shift start and end times for an entire organisation are difficult to institute on a wide scale. Tailoring shift schedules to subgroups within an organisation is suggested.