Arterial hypertension and COVID-19 in Arctic rotating shift work: the impact of chronostructure disruptions on circadian blood pressure rhythm in relation to echocardiographic parameters

This study investigated the effects of chronostructure disruptions on circadian blood pressure (BP) rhythms and their association with echocardiographic parameters in men with arterial hypertension (AH) who contracted COVID-19 while engaged in rotating shift work in the Arctic. Methods – A random sample of 166 men with arterial hypertension (AH) was selected from the medical records database of patients treated at the hospital of the Medical Unit of Gazprom Dobycha Yamburg LLC in Yamburg (Nadymsky District, Russia, 68° 21’ 40” N) between June 2020 and March 2021. Randomization was achieved using a random number method. These patients underwent echocardiography (ECHO) and 24-hour ambulatory blood pressure monitoring (ABPM) before the COVID-19 pandemic (November 2019 to March 2020) and again in 2021. The group was then divided into those who had contracted COVID-19 (n=94) and those who had not (n=72). ABPM was performed using a BPLab v.3.2 device (BPlab, Russia). Chronobiological analysis was performed to identify the main hypertensive BP chronotypes (CT) based on the P. Cugini classification: “MESOR AH”, characterized by a 24-hour rhythm period (T); and “Aperiodic AH”, characterized by a predominance of oscillations with periods (T) of 4.0, 4.8, 6.0, and 8.0 hours within the circadian rhythm. Echocardiography (ECHO) was performed using a Philips CX 50 scanner (Netherlands). Results – Logistic regression analysis showed that the presence of the “Aperiodic AH” chronotype was associated with a threefold increase in the odds of contracting COVID-19, while a 1 g/m² increase in the left ventricular mass index (LVMI) increased these odds by a factor of 1.02. One year post-COVID-19, individuals with “Aperiodic AH”, in contrast to those with “MESOR AH”, exhibited increases in right atrial and inferior vena cava diameters, systolic pulmonary artery pressure, tricuspid regurgitation velocity, stroke volume, and cardiac output, as well as a more pronounced increase in left ventricular mass and LVMI. Associations were observed between structural alterations in the heart and parameters that reflect disruptions in the circadian BP rhythm. Conclusion — Within the context of Arctic rotating shift work, men with arterial hypertension (AH) exhibiting a disrupted chronostructure of the circadian BP rhythm, characterized by a predominance of irregular, short-term oscillations, and structural alterations in the heart, are more susceptible to COVID-19. This increased susceptibility is associated with more pronounced alterations in echocardiographic parameters following the infection.