Hypertension Risks in Cross-Time Zone Pilots: A Cohort Study

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Abstract
Background: The frequency of long-haul, cross-time zone, and nighttime flights is increasing among multiple airlines. Fatigue from long-distance cross-time zone flights may contribute to hypertension onset in civil aviation pilots. Methods: Subjects were stratified into exposure (cross-time zone flights) and non-exposure groups. Pilots with occupational and general risk factors were prospectively followed up, and data were statistically analyzed. Results: Hypertension prevalence differed significantly between groups χ²=302,P<0.05. Overall cohort prevalence was 3.90% (3.97% in exposure, 3.88% in non-exposure), with risk ratio 1.023 and attributable risk 0.09%. Logistic regression showed cross-time zone flights (OR=1.098, 95% CI=1.000–1.205) and family history of hypertension (OR=5.712, 95% CI=2.563–12.729) were independent risk factors, with family history being the most prominent. Conclusion: Our findings guide hypertension management and flight scheduling optimization for long-term cross-time zone pilots.