Association between night shift work and cardiovascular disease: a systematic review and dose-response meta-analysis
Bibliographic record
Abstract
Background: Shift work, particularly night shift work, has become increasingly prevalent on a global scale and is associated with multiple health issues including type 2 diabetes and cardiovascular diseases (CVD). This study aimed to assess the relationship between night shift work and the incidence and mortality of CVD. Method: Six electronic databases including PubMed, Embase, Cochrane Library, Web of Science, CINAHL, and Scopus were searched from inception until August 10, 2025. Cohort studies eligible for inclusion addressed the association between night shift work and outcomes of CVD. STATA 18.0 software was used for meta-analysis. The dose-response relationship was estimated using generalized least squares regression, and restricted cubic splines were used to analyze potential linear or nonlinear associations. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies. Quality assessment and data extraction were performed independently by two researchers. Results: Twenty-three cohort studies were included. Overall, this meta-analysis revealed that night shift work significantly increased the risk of total CVD events (RR = 1.13, 95% CI = 1.10-1.16) and total CVD mortality (RR = 1.27, 95%CI = 1.18-1.36). Dose-response analysis indicated that each 5-year increment in shift work duration was associated with a 7% higher risk of CVD incidence (RR = 1.07, 95% CI: 1.04-1.09) and a 4% increased risk of CVD mortality (RR = 1.05, 95% CI: 1.03-1.06). Subgroup analyses identified elevated risks for incident coronary heart disease (CHD) (RR = 1.22, 95% CI = 1.16-1.28) and ischemic heart disease (IHD) (RR = 1.09, 95% CI = 1.05-1.14), but not stroke (RR = 1.06, 95% CI = 0.95-1.18), and night shift work was associated with an increased risk of mortality due to CHD (RR = 1.22, 95% CI = 1.10-1.36), IHD (RR = 1.39, 95% CI = 1.06-1.84), and stroke (RR = 1.49, 95% CI = 1.04-2.12). Conclusion: These findings indicate that night shift work is significantly associated with increased CVD incidence and mortality risk, highlighting the need for targeted prevention strategies. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251060086. CRD: 420251060086.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.004 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".