Long Working Hours as Risk Factor for Atrial Fibrillation

Study Questions:

Is there a relationship between the number of hours worked and incidence of atrial fibrillation (AF)?

Methods:

The study population was 85,494 working men and women (mean age, 43.4 years) enrolled in the Individual-Participant-Data Meta-analysis in Working Populations Consortium, who had no history of AF. Working hours were assessed at study baseline. Mean follow-up for incident AF was 10 years and cases were defined using data on electrocardiograms, hospital records, drug reimbursement registers, and death certificates.

Results:

A total of 1,061 new cases of AF were identified (10-year cumulative incidence, 12.4 per 1,000). After adjustment for age, sex, and socioeconomic status, individuals working long hours had a 1.4-fold increased risk of AF compared with those working standard hours (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.13–1.80; p = 0.003). The finding remained after excluding participants with coronary heart disease or stroke (n = 2,006; HR, 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.

Conclusions:

Individuals who worked long hours were more likely to develop AF than those working standard hours.

Perspective:

The population studied in this report consisted of 10 cohort studies, none of which individually showed a statistically significant association between the number of hours worked and incidence of AF, but this was the case for the entire studied cohort. The reasons for the association between the hours worked and incident AF are not clear, but it is likely that the higher number of hours worked is associated with unhealthy lifestyle, such as less physical activity, poorer diet, smoking, emotional distress, or a mindset. It is also possible that those who work many hours are more susceptible to overt fatigue in AF, which may have prompted more health visits and a greater chance of diagnosis. The findings should be confirmed in future studies, with repeated ascertainment of the number of hours worked and the type of employment.

Clinical Topics: Arrhythmias and Clinical EP, Diabetes and Cardiometabolic Disease, Prevention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Diet, Exercise, Hypertension, Smoking, Stress

Keywords: Arrhythmias, Cardiac, Atrial Fibrillation, Diet, Electrocardiography, Employment, Exercise, Hospital Records, Hypertension, Life Style, Obesity, Primary Prevention, Risk Factors, Smoking, Stress, Psychological, Work


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