Niijima Satoshi, Nagai Michiaki, Hoshide Satoshi, Takahashi Mami, Shimpo Masahisa, Kario Kazuomi
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Department of General Medicine and Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
J Am Soc Hypertens. 2016 May;10(5):429-37. doi: 10.1016/j.jash.2016.02.010. Epub 2016 Mar 3.
Long and short sleep durations were reported as independently associated with hypertension, aortic stiffness, and cardiovascular disease. High-sensitivity C-reactive protein (hs-CRP) was shown to be associated with increased aortic stiffness. Here, we investigated the relationship between self-reported sleep duration and pulse wave velocity (PWV) in the elderly at high risk of cardiovascular disease. We also investigated whether hs-CRP moderates this relationship. Among 4310 patients with ≥1 cardiovascular risks recruited for the Japan Morning Surge-Home Blood Pressure Study, a questionnaire including items on daily sleep duration was completed. We measured the brachial-ankle PWV (baPWV) and hs-CRP levels in 2304 of these patients (mean age 64.7 years, 49.6% males). In accord with the patients' sleep duration (<6 hours, ≥6 to <8 hours, and ≥8 hours per night), significant associations between sleep duration and the PWV were observed (1594 vs. 1644 vs. 1763 cm/s, P < .0001). In the multiple regression analysis adjusted for age, body mass index, total cholesterol, HbA1c and clinic systolic blood pressure, long sleep duration (≥8 hours per night) (P < .05), and log hs-CRP (P < .05) were significantly positively associated with PWV when the patients with 6- to 8-hour sleep duration were defined as a reference group. Significant interactions of long sleep duration by age and that by antihypertensive medication for baPWV were observed. The effect of long sleep on PWV was greatest in the oldest age group. Long sleep duration and hs-CRP were significant indicators of increased baPWV in this elderly high-risk Japanese population. Age and antihypertensive medication use were significant modulators of the relationship between long sleep duration and arterial stiffness.
据报道,睡眠时间过长和过短均与高血压、主动脉僵硬度和心血管疾病独立相关。高敏C反应蛋白(hs-CRP)与主动脉僵硬度增加有关。在此,我们调查了心血管疾病高危老年人自我报告的睡眠时间与脉搏波速度(PWV)之间的关系。我们还研究了hs-CRP是否调节这种关系。在为日本晨峰-家庭血压研究招募的4310名有≥1种心血管风险的患者中,完成了一份包含每日睡眠时间项目的问卷。我们测量了其中2304名患者(平均年龄64.7岁,男性占49.6%)的臂踝PWV(baPWV)和hs-CRP水平。根据患者的睡眠时间(<6小时、≥6至<8小时、每晚≥8小时),观察到睡眠时间与PWV之间存在显著关联(分别为1594 vs. 1644 vs. 1763 cm/s,P <.0001)。在对年龄、体重指数、总胆固醇、糖化血红蛋白和临床收缩压进行校正的多元回归分析中,当将睡眠时间为6至8小时的患者定义为参照组时,长睡眠时间(每晚≥8小时)(P <.05)和hs-CRP对数(P <.05)与PWV显著正相关。观察到长睡眠时间与年龄以及与降压药物对baPWV存在显著交互作用。长睡眠对PWV的影响在最年长的年龄组中最大。在这个日本高危老年人群中,长睡眠时间和hs-CRP是baPWV升高的显著指标。年龄和降压药物的使用是长睡眠时间与动脉僵硬度之间关系的显著调节因素。