Objectives: Understanding the effect of night shift on hypertension risk in nurses is important to improve the health of nurses and ensure patient safety. This study aimed to evaluate the effect of the frequency and pattern of night shift on hypertension risk and the interaction of them in female nurses.Methods: This cross-sectional study constituted 84 697 female nurses in 13 cities in China. The main contents of the survey included SBP, DBP, the frequency and pattern of night shift, and some other factors that might be associated with hypertension. Logistic regression analyses were used to calculate ORs and 95% CIs to estimate the effect of the frequency and pattern of night shift on hypertension risk and the interaction of them in relation to hypertension risk.Results: Having more than 5 to 10 or more than 10 night shifts per month were significantly more likely to be hypertensive (OR 1.19, 95% CI 1.10-1.28; OR 1.32, 95% CI 1.13-1.54), whereas having less than or equal to 5 night shifts per month was not (OR 1.05, 95% CI 0.95-1.16). The patterns of night shift were all associated with a higher probability of hypertension and participants engaging in rapidly rotating night shift had a lower OR (1.14) than those having slowly rotating night shift (1.23) and permanent night shift (1.46). No significant interaction was observed between the frequency and the pattern of night shift (P interaction ¼ 0.281). Conclusion:The frequency and pattern of night shift were associated with hypertension risk in female nurses and no significant interaction was observed between them.

Night shift is a common work schedule. This study aimed to analyze the interaction between age and frequency of night shift on the hypertension prevalence. A census questionnaire was conducted in 512 medical institutions in 11 cities of Hebei Province. One lakh twenty‐one thousand nine hundred three female nurses were included in this study. Binary Logistic regression analysis was done by SPSS Version 26.0. The youngest age group without night shift was used as the reference group. The odds ratio was calculated by different combinations of interaction items. Interaction coefficients were calculated by an Excel table designed by Andersson. Compared with the 18–25 year old ones without night shift, there existed an additive interaction between the age of 36–45 and more than 5–10 night shifts per month on hypertension prevalence. Odds ratio, the relative excess risk of interaction, the attributable proportion of interaction, and the synergy index and their 95% confidence intervals were 2.923(2.292‐3.727), 0.631(0.309‐0.954), 0.216(0.109‐0.323), 1.488(1.158‐1.913). Additive interaction was also found between the age of 36–45 and more than 10 night shifts per month. OR, RERI, API, SI, and their 95% confidence intervals were 3.430(2.273‐5.175) 1.037(0.061‐2.013), 0.303(0.089‐0.516), and 1.746(1.093‐2.788). There also existed an additive interaction between the age of 46–65 and more than 5–10 night shifts per month on hypertension prevalence. OR, RERI, API, SI, and their 95% confidence intervals were 7.398(5.595‐9.781) 1.809(0.880‐2.739), 0.245(0.148‐0.341), and 1.394(1.199‐1.622).There existed interaction between specific age groups and night shift frequency on the prevalence of hypertension among female nurses.

ObjectivesThis study aimed to elucidate the status of hypertension and to analyse the hypertension changes in prevalence, awareness, treatment and control rate among the portion of Chinese nursing staff based on the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) High Blood Pressure Guideline and the 2010 Chinese Guideline for the Management of Hypertension.DesignCross-sectional study.Setting512 medical institutions in 13 cities in Hebei Province.ParticipantsThe candidates of registered nurses from 512 medical institutions in 13 cities in Hebei Province (N=143 772) were invited to participate in the survey, and few of them who refused to participate were excluded from the research group based on the reasons that 93 603 incumbent nurses at the age of 18–65 accepted to the survey and submitted questionnaires online. Undoubtedly, a response rate of 65.11% was achieved. After excluding 788 individuals with incomplete information in the questionnaires, 92 815 participants were included in the final analysis.Main outcome measuresThe prevalence, awareness, treatment and control rates of hypertension.Results92 815 participants were included in the final analysis, among which consisted of 3677 men (3.96%) and 89 138 women (96.04%). The mean age of the participants was 31.65 (SD=7.47) years.We demonstrated that 26 875 nursing staff were diagnosed as having hypertension according to the new standard by the 2017 ACC/AHA guideline, more than 20 551 cases compared with the previous threshold on the 2010 Chinese guideline. The prevalence of hypertension among nursing staff was 28.96% in the context of the 2017 ACC/AHA guideline, 3.25 times higher than that (6.81%) evaluated by the criteria of the 2010 Chinese guideline. However, the awareness, treatment and control rate (13.50%, 10.73% and 0.81%) were 3.25, 3.22 and 17.48 times lower than those (57.37%, 45.30% and 14.97%) based on the 2010 Chinese guideline, respectively.ConclusionsThis research illustrated that it was crucial to improve the awareness rate, drug treatment rate and control rate of hypertension for nurses. Meanwhile, according to the 2017 ACC/AHA guideline, the prevalence of hypertension in China will increase significantly, which poses a more severe challenge to the management of hypertension in China.

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Objective: Our aim for this study was to develop a model using clinical, laboratory and echocardiographic factors, in addition to CHA2DS2-VASC score, to increase predictability of AF related stroke in patients with non-valvular atrial fibrillation (NVAF).Methods: We retrospectively analyzed the medical history, clinical characteristics, laboratory and echocardiographic data of 373 patients with NVAF.Results: In multiple logistic regression, CHA2DAS2 VASC score (OR 1.22 (95%CI 1.04-1.43), P=0.016), anion gap (OR 1.19 (95%CI 1.08-1.30), P < 0.001), e-peak deceleration time （EDT） (OR 1.01 (95%CI 1.00-1.01), P=0.001) and the left atrial appendage emptying rate （LAAEV） (OR 0.99 (95%CI 0.97-0.99), P=0.013) were risk factors for predicting stroke in NVAF patients. For patients with low CHA2DAS2 VASC score, anion gap (OR 1.35 (95%CI 1.03-1.77), P=0.028) and EDT (OR 1.01 (95%CI 1.00-1.02), P=0.043) were associated with stroke.Receiver operating characteristic (ROC) curve showed that area under curve (AUC) is 11% higher in the model including anion gap, EDT， LAAEV and CHA2DS2-VASc score, compared to only using CHA2DS2-VASc score as predictor (0.70 (95%CI 0.64-0.75) vs 0.59 (95%CI 0.54-0.65)).Conclusions: Our study showed that incorporating anion gap, EDT and LAAEV into CHA2DS2-VASC score increases the ability to predict atrial fibrillation related stroke.