Shift work and early vascular aging: a systematic review

People worldwide are increasingly engaged in shift work across modern industries. This might have long-term health implications, including early vascular aging (EVA) characterized by modified vascular structures, impaired vascular function, and changed circulatory indicators. Evaluating the relationship between EVA indicators and shift work could provide valuable insights into changes in vascular health. However, this relationship remains a matter of debate.

We conducted a systematic review across five databases to identify the relationship between shift work and EVA, with outcomes based on vascular structures, functions, and circulatory indicators.

This systematic review included 33 articles published up to February 2025, including 28 cross-sectional and five longitudinal studies. Night shift, 24-hour shift, and on call shift were all examined in this review. Available longitudinal literature was consistent in showing a relationship between the continuous years spent working shifts and increased pulse wave velocity (n = 3), as well as increased thickness of the carotid artery (n = 2). However, evidence from cross-sectional studies have been inconsistent, with insignificant correlations reported for vascular structures (4/10) and functions (4/8). Across various samples and settings, shift work was found to be positively associated with inflammatory factors and negatively associated with antioxidant levels (17/19).

Variations in organizational and regional policies result in differing rest periods and working conditions among shift workers. The association between shift work and EVA remains uncertain due to inconsistencies across studies and the lack of a standardized definition of shift work. Future research should establish widely accepted evaluation systems and incorporate individual lifestyle factors to enable more effective and targeted intervention strategies for shift workers.