San Diego Veterans Affairs Healthcare System, Medicine Service, San Diego, CA 92161, USA.
Hypertension. 2011 Oct;58(4):596-603. doi: 10.1161/HYPERTENSIONAHA.111.174409. Epub 2011 Aug 29.
The importance of sleep to health and cardiovascular disease has become increasingly apparent. Sleep-disordered breathing, sleep duration, and sleep architecture may all influence metabolism and neurohormonal systems, yet no previous study has evaluated these sleep characteristics concurrently in relation to incident hypertension. Our objective was to determine whether incident hypertension is associated with polysomnography measures of sleep-disordered breathing, sleep duration, and sleep architecture in older men. Participants were 784 community-dwelling, ambulatory men ≥65 years of age (mean age: 75.1±4.9 years) from the Outcomes of Sleep Disorders in Older Men Study who did not have hypertension at the time of their in-home polysomnography sleep studies (2003-2005) and who returned for follow-up (2007-2009). Of 784 older men included in this report, 243 met criteria for incident hypertension after a mean follow-up of 3.4 years. In unadjusted analyses, incident hypertension was associated with increased hypoxemia, increased sleep stages N1 and N2, and decreased stage N3 (slow wave sleep [SWS]). After adjustment for age, nonwhite race, study site, and body mass index, the only sleep index to remain significantly associated with incident hypertension was SWS percentage (odds ratio for lowest to highest quartile of SWS: 1.83 [95% CI: 1.18 to 2.85]). No attenuation of this association was seen after accounting for sleep duration, sleep fragmentation, and indices of sleep-disordered breathing. Percentage time in SWS was inversely associated with incident hypertension, independent of sleep duration and fragmentation, and sleep-disordered breathing. Selective deprivation of SWS may contribute to adverse blood pressure in older men.
睡眠对健康和心血管疾病的重要性日益明显。睡眠呼吸障碍、睡眠时间和睡眠结构都可能影响代谢和神经激素系统，但以前的研究尚未评估这些睡眠特征与高血压的发生之间的关系。我们的目的是确定老年人中睡眠呼吸障碍、睡眠时间和睡眠结构的多导睡眠图测量指标与高血压的发生是否有关。参与者为来自老年男性睡眠障碍结局研究的 784 名社区居住、有活动能力的男性，年龄≥65 岁（平均年龄：75.1±4.9 岁），在进行家庭多导睡眠图睡眠研究（2003-2005 年）时没有高血压，并且在随访（2007-2009 年）时返回。在本报告中纳入的 784 名老年男性中，243 名在平均 3.4 年的随访后符合高血压发生的标准。在未调整分析中，高血压的发生与低氧血症增加、睡眠期 N1 和 N2 增加以及 N3 期（慢波睡眠 [SWS]）减少有关。在调整年龄、非白种人、研究地点和体重指数后，与高血压发生显著相关的唯一睡眠指标仍然是 SWS 百分比（最低到最高 SWS 四分位数的比值比：1.83 [95% CI：1.18 至 2.85]）。在考虑到睡眠时间、睡眠片段化和睡眠呼吸障碍指标后，这种关联并未减弱。SWS 时间百分比与高血压的发生呈负相关，与睡眠时间和片段化以及睡眠呼吸障碍无关。SWS 的选择性剥夺可能导致老年男性血压升高。
