San Diego Veterans Affairs Healthcare System, Medicine Service, 3550 La Jolla Village Dr., San Diego, CA, USA.
J Clin Sleep Med. 2013 Jun 15;9(6):585-91. doi: 10.5664/jcsm.2756.
To evaluate whether actigraphy-measured total sleep time and other sleep characteristics predict incident hypertension in older men.
Study subjects were community-dwelling participants in the ancillary sleep study of the Osteoporotic Fractures in Men Study (MrOS) who were normotensive at the time of actigraphy (based on self-report, lack of antihypertensive medication use, and with systolic blood pressure < 140 mm Hg and diastolic blood pressure < 90 mm Hg). In 853 community-dwelling men 67 years and older (mean 75.1 years), sleep measures (total sleep time [TST]), percent sleep [%-sleep], latency, and wake after sleep onset [WASO]) were obtained using validated wrist actigraphy with data collected over a mean duration of 5.2 consecutive 24-h periods. We evaluated incident hypertension (based on self-report, use of antihypertensive medication, or measured systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm Hg) at a follow-up visit an average of 3.4 years later. Baseline prehypertension was defined as a systolic blood pressure 120 to < 140 mm Hg or diastolic blood pressure 80 to < 90 mm Hg.
At follow-up, 31% of initially normotensive men were hypertensive (264 of 853). Those with incident hypertension had higher baseline body mass index (BMI; kg/m(2)) and were more likely to have had prehypertension at the sleep visit than those men who remained normotensive. However, neither TST (reference 6 to < 8 h; < 6 h OR 0.96 [95% CI 0.7, 1.3] and ≥ 8 h OR 0.93 [0.5, 1.7]) nor the other actigraphic-measured sleep variables, including % -sleep (reference > 85%; < 70% OR 1.17 [0.66, 2.08]) and 70% to ≤ 85% OR 1.23 (0.9, 1.68), sleep latency (reference < 30 min; ≥ 30 min OR 1.29 [0.94, 1.76]), or WASO (reference < 30 min; 30 to < 60 min OR 0.7 [0.43, 1.14] and ≥ 60 min OR 0.92 [0.58, 1.47]) differed in those community-dwelling men who developed incident hypertension compared to those who remained normotensive.
TST and other sleep parameters determined by wrist actigraphy were not associated with incident hypertension in community-dwelling older men.
评估活动计测量的总睡眠时间和其他睡眠特征是否可预测老年男性中高血压的发生。
本研究的研究对象为男性骨质疏松症研究(MrOS)辅助睡眠研究中的社区居住参与者,这些参与者在进行活动计时(基于自我报告、未使用抗高血压药物以及收缩压<140mmHg 和舒张压<90mmHg)时血压正常。在 853 名年龄在 67 岁及以上(平均 75.1 岁)的社区居住男性中,使用经过验证的腕部活动计测量了睡眠指标(总睡眠时间[TST])、睡眠百分比[-睡眠]、潜伏期和睡眠后觉醒时间[WASO]),数据采集时间平均为 5.2 个连续的 24 小时周期。在平均 3.4 年的随访中,根据自我报告、使用抗高血压药物或测量的收缩压≥140mmHg 或舒张压≥90mmHg,评估新发高血压(基于自我报告、使用抗高血压药物或测量的收缩压≥140mmHg 或舒张压≥90mmHg)。基线前期高血压定义为收缩压 120-<140mmHg 或舒张压 80-<90mmHg。
随访时,最初血压正常的男性中有 31%(853 名中的 264 名)患有高血压。与那些保持血压正常的男性相比,患有新发高血压的男性基线时体重指数(BMI;kg/m2)更高,并且在睡眠检查时更有可能患有前期高血压。然而,无论是 TST(参考值为 6-<8 小时;<6 小时 OR 0.96[0.7,1.3]和≥8 小时 OR 0.93[0.5,1.7])还是其他通过活动计测量的睡眠变量,包括%-睡眠(参考值>85%;<70% OR 1.17[0.66,2.08]和 70%-≤85% OR 1.23[0.9,1.68])、睡眠潜伏期(参考值<30 分钟;≥30 分钟 OR 1.29[0.94,1.76])或 WASO(参考值<30 分钟;30-<60 分钟 OR 0.7[0.43,1.14]和≥60 分钟 OR 0.92[0.58,1.47])在发生新发高血压的社区居住男性中与那些保持血压正常的男性相比并无差异。
在社区居住的老年男性中,通过腕部活动计测量的 TST 和其他睡眠参数与新发高血压无关。