The AMBITIOUS study design and rationale: Ambulatory blood pressure in Taiwanese occupational healthcare staff

Background: Sudden death is a rare but real threat to hospital-based physicians and surgeons. The association between sudden death and blood pressure (BP) fluctuations in healthcare providers has not been documented. We hypothesized that work-shift loading may lead to variable BP surges in hospital-based healthcare staff, which might contribute to their development of cardiovascular disease. Methods: Our intention is to ask 150 healthcare staff (doctors, medical technicians, and nurses) working in the coronary catheterization lab, intensive care unit, and the medical wards, respectively, to volunteer for the study. Their changes in BP would automatically be recorded every 60 minutes on an ambulatory BP monitoring machine for 24 hours during a normal workday. All events and activities would be recorded in a diary, which would allow us to coordinate BP changes with the work being done during the shift. All cardiovascular outcomes would be followed-up for a five-year duration. Conclusions: We herein report the rationale and design of this first multicenter trial in Taiwan to explore the BP behavior associated with long work shifts in healthy hospital-based healthcare providers.