Long working hours as a risk factor for atrial fibrillation: A multi-cohort study

Mika Kivimäki; Solja T. Nyberg; G. David Batty; Ichiro Kawachi; Markus Jokela; Lars Alfredsson; Jakob B. Bjorner; Marianne Borritz; Hermann Burr; Nico Dragano; Eleonor I. Fransson; Katriina Heikkilä; Anders Knutsson; Markku Koskenvuo; Meena Kumari; Ida E.H. Madsen; Martin L. Nielsen; Maria Nordin; Tuula Oksanen; Jan H. Pejtersen; Jaana Pentti; Reiner Rugulies; Paula Salo; Martin J. Shipley; Sakari Suominen; Töres Theorell; Jussi Vahtera; Peter Westerholm; Hugo Westerlund; Andrew Steptoe; Archana Singh-Manoux; Mark Hamer; Jane E. Ferrie; Marianna Virtanen; Adam G. Tabak

doi:10.1093/eurheartj/ehx324

Long working hours as a risk factor for atrial fibrillation: A multi-cohort study

Mika Kivimäki^*, Solja T. Nyberg, G. David Batty, Ichiro Kawachi, Markus Jokela, Lars Alfredsson, Jakob B. Bjorner, Marianne Borritz, Hermann Burr, Nico Dragano, Eleonor I. Fransson, Katriina Heikkilä, Anders Knutsson, Markku Koskenvuo, Meena Kumari, Ida E.H. Madsen, Martin L. Nielsen, Maria Nordin, Tuula Oksanen, Jan H. PejtersenJaana Pentti, Reiner Rugulies, Paula Salo, Martin J. Shipley, Sakari Suominen, Töres Theorell, Jussi Vahtera, Peter Westerholm, Hugo Westerlund, Andrew Steptoe, Archana Singh-Manoux, Mark Hamer, Jane E. Ferrie, Marianna Virtanen, Adam G. Tabak

^*Corresponding author af dette arbejde

Institut for Folkesundhedsvidenskab

38 Citationer (Scopus)

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Abstract

Aims Studies 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 results In 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. Conclusion Individuals who worked long hours were more likely to develop atrial fibrillation than those working standard hours.

Originalsprog	Engelsk
Tidsskrift	European Heart Journal
Vol/bind	38
Udgave nummer	34
Sider (fra-til)	2621-2628
Antal sider	8
ISSN	0195-668X
DOI	https://doi.org/10.1093/eurheartj/ehx324
Status	Udgivet - 7 sep. 2017

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Kivimäki, M., Nyberg, S. T., Batty, G. D., Kawachi, I., Jokela, M., Alfredsson, L., Bjorner, J. B., Borritz, M., Burr, H., Dragano, N., Fransson, E. I., Heikkilä, K., Knutsson, A., Koskenvuo, M., Kumari, M., Madsen, I. E. H., Nielsen, M. L., Nordin, M., Oksanen, T., ... Tabak, A. G. (2017). Long working hours as a risk factor for atrial fibrillation: A multi-cohort study. European Heart Journal, 38(34), 2621-2628. https://doi.org/10.1093/eurheartj/ehx324

Kivimäki, M, Nyberg, ST, Batty, GD, Kawachi, I, Jokela, M, Alfredsson, L, Bjorner, JB, Borritz, M, Burr, H, Dragano, N, Fransson, EI, Heikkilä, K, Knutsson, A, Koskenvuo, M, Kumari, M, Madsen, IEH, Nielsen, ML, Nordin, M, Oksanen, T, Pejtersen, JH, Pentti, J, Rugulies, R, Salo, P, Shipley, MJ, Suominen, S, Theorell, T, Vahtera, J, Westerholm, P, Westerlund, H, Steptoe, A, Singh-Manoux, A, Hamer, M, Ferrie, JE, Virtanen, M & Tabak, AG 2017, 'Long working hours as a risk factor for atrial fibrillation: A multi-cohort study', European Heart Journal, bind 38, nr. 34, s. 2621-2628. https://doi.org/10.1093/eurheartj/ehx324

@article{b459e1dd39b14b5786715137047887f3,

title = "Long working hours as a risk factor for atrial fibrillation: A multi-cohort study",

abstract = "Aims Studies 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 results In 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. Conclusion Individuals who worked long hours were more likely to develop atrial fibrillation than those working standard hours.",

keywords = "Atrial fibrillation, Cohort study, Life stress, Risk factors",

author = "Mika Kivim{\"a}ki and Nyberg, {Solja T.} and Batty, {G. David} and Ichiro Kawachi and Markus Jokela and Lars Alfredsson and Bjorner, {Jakob B.} and Marianne Borritz and Hermann Burr and Nico Dragano and Fransson, {Eleonor I.} and Katriina Heikkil{\"a} and Anders Knutsson and Markku Koskenvuo and Meena Kumari and Madsen, {Ida E.H.} and Nielsen, {Martin L.} and Maria Nordin and Tuula Oksanen and Pejtersen, {Jan H.} and Jaana Pentti and Reiner Rugulies and Paula Salo and Shipley, {Martin J.} and Sakari Suominen and T{\"o}res Theorell and Jussi Vahtera and Peter Westerholm and Hugo Westerlund and Andrew Steptoe and Archana Singh-Manoux and Mark Hamer and Ferrie, {Jane E.} and Marianna Virtanen and Tabak, {Adam G.}",

year = "2017",

month = sep,

day = "7",

doi = "10.1093/eurheartj/ehx324",

language = "English",

volume = "38",

pages = "2621--2628",

journal = "European Heart Journal",

issn = "0195-668X",

publisher = "Oxford University Press",

number = "34",

}

TY - JOUR

T1 - Long working hours as a risk factor for atrial fibrillation

T2 - A multi-cohort study

AU - Kivimäki, Mika

AU - Nyberg, Solja T.

AU - Batty, G. David

AU - Kawachi, Ichiro

AU - Jokela, Markus

AU - Alfredsson, Lars

AU - Bjorner, Jakob B.

AU - Borritz, Marianne

AU - Burr, Hermann

AU - Dragano, Nico

AU - Fransson, Eleonor I.

AU - Heikkilä, Katriina

AU - Knutsson, Anders

AU - Koskenvuo, Markku

AU - Kumari, Meena

AU - Madsen, Ida E.H.

AU - Nielsen, Martin L.

AU - Nordin, Maria

AU - Oksanen, Tuula

AU - Pejtersen, Jan H.

AU - Pentti, Jaana

AU - Rugulies, Reiner

AU - Salo, Paula

AU - Shipley, Martin J.

AU - Suominen, Sakari

AU - Theorell, Töres

AU - Vahtera, Jussi

AU - Westerholm, Peter

AU - Westerlund, Hugo

AU - Steptoe, Andrew

AU - Singh-Manoux, Archana

AU - Hamer, Mark

AU - Ferrie, Jane E.

AU - Virtanen, Marianna

AU - Tabak, Adam G.

PY - 2017/9/7

Y1 - 2017/9/7

N2 - Aims Studies 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 results In 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. Conclusion Individuals who worked long hours were more likely to develop atrial fibrillation than those working standard hours.

AB - Aims Studies 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 results In 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. Conclusion Individuals who worked long hours were more likely to develop atrial fibrillation than those working standard hours.

KW - Atrial fibrillation

KW - Cohort study

KW - Life stress

KW - Risk factors

UR - http://www.scopus.com/inward/record.url?scp=85029764375&partnerID=8YFLogxK

U2 - 10.1093/eurheartj/ehx324

DO - 10.1093/eurheartj/ehx324

M3 - Journal article

C2 - 28911189

AN - SCOPUS:85029764375

SN - 0195-668X

VL - 38

SP - 2621

EP - 2628

JO - European Heart Journal

JF - European Heart Journal

IS - 34

ER -

Long working hours as a risk factor for atrial fibrillation: A multi-cohort study

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