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Systematic review and meta-analysis of the association between long working hours and hypertension risk
  1. Joonho Ahn1,
  2. Ji-Hun Song2,
  3. In-Soo Shin3,
  4. In Young Cho4,
  5. Mo-Yeol Kang5
  1. 1 Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  2. 2 Gong-gam Center for Occupational and Environmental Medicine, Hyangnam Gong-gam Clinic, Hwasung, Gyeonggi-do, Republic of Korea
  3. 3 Graduate School of Education. Dongguk University, Seoul, Republic of Korea
  4. 4 Department of Family Medicine, amsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  5. 5 Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
  1. Correspondence to Dr Mo-Yeol Kang, Seoul Saint Mary's Hospital, Seoul, Korea; snaptoon{at}


Background Hypertension, a major public health problem worldwide, has been linked to lifestyle factors and work conditions, with conflicting evidence on the association between long work hours and risk of hypertension.

Methods We conducted a systematic review and meta-analysis of observational studies to investigate the relationship between working hours and hypertension or blood pressure, assessed the risk of bias and performed subgroup analyses. The protocol was registered with the International Prospective Register of Systematic Reviews.

Results The pooled OR for the association between long working hours and risk of hypertension was 1.09 (95% CI: 0.88 to 1.35) in the 15 studies that used hypertension as the outcome. In the three studies that used blood pressure as the outcome, diastolic blood pressure was higher among those with long working hours compared with those with non-long working hours (1.24 mm Hg, 95% CI: 0.19 to 2.29). In subgroup analysis, the pooled OR for the association between long working hours and risk of hypertension was 1.28 (95% CI: 1.14 to 1.44) and 1.00 (95% CI: 0.64 to 1.56) in women and men, respectively.

Conclusions Although this study could not clearly confirm the relationship between long working hours and hypertension, the subgroup analysis suggests that long working hours may be associated with hypertension, particularly among women. More reliable research is needed to establish causality.

PROSPERO registration number CRD42023406961.


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  • Contributors All authors discussed the results and commented on the manuscript. Specifically, M-YK conceptualised and supervised the study. JA and J-HS collected the data. JA analysed the data. JA and M-YK wrote and prepared the manuscript. Additionally, M-YK is the guarantor, accepting full responsibility for the work, having access to the data, and controlling the decision to publish.

  • Funding This research is supported by National Research Foundation of Korea (NRF-2022R1F1A1066498).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.