Relationship of arterial and cardiac stiffness in rotating shift workers in the Arctic

Objective. To investigate factors associated with arterial hypertension (HTN), evaluate their interrelationship in rotational shift workers in the Arctic.

Design and methods. In the polar settlement of Yamburg (68 N), on the basis of Health Service LLC “Gazprom Dobycha Yamburg” medical unit, 183 out of 213 subjects were enrolled in the study: 100 males (M) aged 48,8 ± 8,4 years, 83 females (F) aged 49,7 ± 7,1 years (p = 0,443), comparable in te duration of rotational shift work: 16,5 ± 8,6 and 16,3 ± 8,9 years, respectively. Patients were divided into 2 groups according to the level of blood pressure (BP): Group 1 (Gr. 1) included 86 individuals with HTN1, 2 stages (BP > 140/90 mm Hg); Group 2 (Gr. 2) comprised 97 individuals with BP < 140/90 mm Hg. Ultrasound examination of carotid arteries was performed, and the indicators of local arterial stiffness (Peterson’s elastic modulus (Ep), β-stiffness) were assessed. The following diagnostic procedures were performed: ambulatory BP monitoring; cardio-ankle vascular index (CAVI) and pulse wave velocity (PWV) assessment; echocardiography with the assessment of probability for heart failure with preserved ejection fraction (HFpEF) by the H2FPEF score (Heavy; Hypertensive; Atrial Fibrillation; Pulmonary Hypertension; Elder; Filling Pressure); biochemical blood tests with the evaluation of homocysteine, high-sensitivity C-reactive protein (hs-CRP), pro-brain natriuretic peptide (pro-BNP).

Results. In Gr. 1 vs Gr. 2, elevated levels of left CAVI (p = 0,022) and right CAVI (р = 0,045) were registered; PWV in Gr. 1 was significantly higher than in Gr. 2 [right (p < 0,001) and left (p < 0,001)], and homocysteine (p = 0,025) level was higher in HTN group. Probability of HFpEF by the H2FPEF score was higher in Gr. 1 than in Gr. 2 (р < 0,001). According to logistic regression analysis, there was a relationship between HTN and PWV (odds ratio (OR) = 1,44; 95% confidence interval (CI) 1,22–1,75), 24-hour diastolic BP variability (DBPV24) (OR = 1,16; 95% CI 1,01–1,38), with the probability of HFpEF (OR = 1,67; 95% CI 1,23–2,33). Peterson’s elastic modulus (Ep) correlated with left ventricular myocardial mass (LVMM) (r = 0,39, p < 0,01), left ventricular myocardial mass index (LVMMI) (r = 0,39, p < 0,01), HFpEF probability (r = 0,27, p < 0,01); while β-stiffness index of common carotid arteries correlated with LVMM (r = 0,25, p < 0,01).

Conclusions. According to logistic regression analysis results, relationship between PWV, DBPV24 and signs of HFpEF by the H2FPEF score and HTN was registered in rotational shift workers in the Arctic region. Obtained data defined HTN as a risk factor for HFpEF even in asymptomatic patients and might be taken into account for cardiovascular prevention in terms of rotational shift work. The associations of arterial stiffness with LVMM and LVMMI, signs of HFpEF by the H2FPEF score may indicate simultaneous interconnected processes of arterial and cardiac stiffness formation.

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