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Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments

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Sex Differences in 24 H Blood Pressure in Night-Shift Workers.

Barbara Toffoli¹, Silvia Berti¹, Ilaria Pitteri¹

¹Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34100 Trieste, Italy.

Journal of Clinical Medicine

|August 28, 2025

Summary

This study reveals sex differences in blood pressure responses to night-shift work. While males had higher blood pressure, females showed decreased tolerance to shift work, potentially linked to circadian rhythm variations.

Keywords:

BMAL1 blood pressure circadian rhythm clock genes gender medicine hypertension night shift sex differences shift work

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Area of Science:

Cardiovascular Physiology
Gender Medicine
Chronobiology

Background:

Blood pressure (BP) is a key cardiovascular disease risk factor and exhibits sexual dimorphism.
Shift work, particularly night shifts, is linked to hypertension, but sex-specific effects are not well-understood.
Gender Medicine investigates sex- and gender-based health differences.

Purpose of the Study:

To investigate sex differences in 24-hour blood pressure profiles during day shifts versus night shifts.
To explore how night-shift work impacts blood pressure regulation in males and females.

Main Methods:

Post hoc analysis of ambulatory blood pressure monitoring data from a previous study.
Comparison of 24-hour BP profiles across two conditions: a day with a day shift and a day with a night shift.
Analysis of 25 physicians (10 males, 15 females) with low exposure to night-shift work.

Main Results:

Males consistently exhibited higher blood pressure levels than females.
Females showed a significant increase in systolic blood pressure (SBP) during the night shift compared to a rest night.
Both sexes had reduced BP dipping during night shifts, but females maintained this reduction post-shift. BMAL1 gene expression increased post-night shift only in females.

Conclusions:

Blood pressure regulation demonstrates significant sex/gender differences.
Females may have lower tolerance to shift work, potentially due to sex-specific circadian rhythm regulation affecting BP.
These findings highlight the importance of considering sex in understanding shift work's cardiovascular impact.