Shivashankar Roopa, Kondal Dimple, Ali Mohammed K, Gupta Ruby, Pradeepa Rajendra, Mohan Viswanathan, Kadir Muhammad Masood, Narayan K M Venkat, Tandon Nikhil, Prabhakaran Dorairaj, Peasey Anne
Centre for Control of Chronic Conditions (4C), New Delhi, India.
Public Health Foundation of India, New Delhi, India.
Sleep. 2017 Sep 1;40(9). doi: 10.1093/sleep/zsx119.
Sleep duration and disturbances may be risk factors for hypertension. Despite the high burden of hypertension in South Asia, little is known about this relationship in this region.
We analyzed population-level cross-sectional data from the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) study that recruited representative samples of adults ≥ 20 years from three cities-Delhi, Chennai (India), and Karachi (Pakistan) during 2010-2011. We defined hypertension as self-reported treatment or measured blood pressure (BP) ≥140/90 mm Hg. Data on usual duration of sleep, insomnia, and snoring were collected using "The Sleep Habits Questionnaire" and excessive daytime sleepiness (EDS) using Epworth Sleepiness Score. Logistic and linear regression were done with hypertension and BP as outcome variables, respectively. Age, gender, education, wealth index, family history, and body mass index (BMI) were included as covariates. We used multiple imputation to account for missing variables.
Prevalence of hypertension was 30.1%. The mean (SD) sleep duration was 7.3 (1.2) hours. Insomnia, snoring, and EDS were present in 13.6%, 28.7%, and 4.6%, respectively. Moderate and habitual snoring were associated with increased odds of hypertension (odds ratio [OR] = 1.18, 95% confidence interval [CI] [1.04 to 1.33] and 1.47 [1.29 to 1.67], respectively), after adjusting for covariates. Rare, occasional, and frequent insomnia were associated with increased hypertension (OR 1.41 [1.12 to 1.77], 1.39 [1.16 to 1.67], and 1.34 [1.09 to 1.65], respectively). Sleep duration and EDS were not associated with hypertension.
Self-reported snoring and insomnia were associated with hypertension in South Asia. This relationship needs further exploration through robust longitudinal studies in this region.
睡眠时间和睡眠障碍可能是高血压的危险因素。尽管南亚地区高血压负担沉重，但该地区对这种关系却知之甚少。
我们分析了南亚心血管代谢风险降低中心（CARRS）研究中的人群水平横断面数据，该研究在2010 - 2011年期间从德里、金奈（印度）和卡拉奇（巴基斯坦）三个城市招募了年龄≥20岁的具有代表性的成年人样本。我们将高血压定义为自我报告的治疗情况或测量的血压（BP）≥140/90 mmHg。使用“睡眠习惯问卷”收集关于通常睡眠时间、失眠和打鼾的数据，并使用爱泼华嗜睡量表收集白天过度嗜睡（EDS）的数据。分别以高血压和血压作为结果变量进行逻辑回归和线性回归。年龄、性别、教育程度、财富指数、家族病史和体重指数（BMI）作为协变量纳入。我们使用多重填补法处理缺失变量。
高血压患病率为30.1%。平均（标准差）睡眠时间为(7.3)（(1.2)）小时。失眠、打鼾和EDS的发生率分别为13.6%、28.7%和4.6%。在调整协变量后，中度和习惯性打鼾与高血压几率增加相关（优势比[OR]分别为1.18，95%置信区间[CI][1.04至1.33]和1.47[1.29至1.67]）。罕见、偶尔和频繁失眠与高血压增加相关（OR分别为1.41[1.12至1.77]、1.39[1.16至1.67]和1.34[1.09至1.65]）。睡眠时间和EDS与高血压无关。
在南亚，自我报告的打鼾和失眠与高血压相关。这种关系需要通过该地区强有力的纵向研究进一步探索。
