Rogers April, Necola Olivia, Sexias Azizi, Luka Alla, Newsome Valerie, Williams Stephen, McFarlane Samy I, Jean-Louis Girardin
Center for Healthful Behavior Change (CHBC), Division of Health and Behavior, Department of Population Health, New York University Medical Center, New York, NY 10016, USA.
Department of Medicine, Westchester Medical Center, Valhalla, NY 10595, USA.
J Sleep Disord Treat Care. 2016;5(4). doi: 10.4172/2325-9639.1000183. Epub 2016 Aug 12.
Resistant hypertension (RHTN) is an important condition affecting 29% of the hypertensive population in the U.S., especially among blacks. Sleep disturbances, like obstructive sleep apnea, insomnia, and short sleep duration, are increasingly recognized as underlying modifiable factors for RHTN. We evaluated associations of RHTN with short sleep duration among blacks with metabolic syndrome.
Data from the Metabolic Syndrome Outcome Study (MetSO), a NIH-funded cohort study characterizing metabolic syndrome (MetS) among blacks were analyzed. MetS was defined according to criteria from the Adult Treatment Panel (ATP III). RHTN was defined according to guidelines from the American Heart Association. Short sleep was defined as self-reported sleep duration <7 hrs experienced during a 24-hour period.
Analysis was based on 1,035 patients (mean age: 62±14years; female: 69.2%). Of the sample, 90.4% were overweight /obese; 61.4% had diabetes; 74.8% had dyslipidemia; 30.2% had a history of heart disease; and 48% were at high risk for obstructive sleep apnea. Overall, 92.6% reported physician-diagnosed hypertension (HTN) and 20.8% met criteria for RHTN. Analyses showed those with RHTN were more likely to be short sleepers (26.8% vs. 14.9%, p< 0.001). Based on logistic regression analysis, adjusting for effects of age, sex, and medical comorbidities, patients with metabolic syndrome and RHTN had increased odds of being short sleepers (OR = 1.95, 95% CI: 1.28-2.97, p = 0.002).
Among blacks with metabolic syndrome, patients meeting criteria for resistant hypertension showed a twofold greater likelihood of being short sleepers, prompting the need for sleep screening in this vulnerable population.
难治性高血压（RHTN）是一种重要疾病，影响着美国29%的高血压人群，在黑人中尤为常见。睡眠障碍，如阻塞性睡眠呼吸暂停、失眠和短睡眠时间，越来越被认为是RHTN潜在的可改变因素。我们评估了患有代谢综合征的黑人中RHTN与短睡眠时间之间的关联。
分析了代谢综合征结局研究（MetSO）的数据，该研究是一项由美国国立卫生研究院资助的队列研究，旨在描述黑人中的代谢综合征（MetS）。MetS根据成人治疗小组（ATP III）的标准定义。RHTN根据美国心脏协会的指南定义。短睡眠被定义为自我报告的24小时内睡眠时间<7小时。
分析基于1035名患者（平均年龄：62±14岁；女性：69.2%）。在样本中，90.4%超重/肥胖；61.4%患有糖尿病；74.8%患有血脂异常；30.2%有心脏病史；48%有阻塞性睡眠呼吸暂停的高风险。总体而言，92.6%报告有医生诊断的高血压（HTN），20.8%符合RHTN标准。分析表明，患有RHTN的人更有可能是短睡眠者（26.8%对14.9%，p<0.001）。基于逻辑回归分析，在调整年龄、性别和合并症的影响后，患有代谢综合征和RHTN的患者成为短睡眠者的几率增加（OR = 1.95，95% CI：1.28 - 2.97，p = 0.002）。
在患有代谢综合征的黑人中，符合难治性高血压标准的患者成为短睡眠者的可能性高出两倍，这促使有必要对这一脆弱人群进行睡眠筛查。
