Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, PR China.
Sleep Med. 2019 Jun;58:27-34. doi: 10.1016/j.sleep.2019.03.001. Epub 2019 Mar 16.
This study investigated the association between poor sleep quality and hypertension, and evaluated how the Pittsburgh Sleep Quality Index (PSQI) score correlates with blood pressure and prevalent hypertension.
A total of 27, 912 participants aged 18-79 years from the Henan Rural Cohort Study were included into the current study. PSQI score was classified as <3, 3-, 6-, ≥9. Multivariate logistic regression models and restricted cubic spline with hypertension as a dependent variable were conducted. A meta-analysis was conducted to validate the result of the cross-sectional study.
Altogether, 6,085 (21.80%) were poor sleepers and 9,056 (32.44%) suffered from hypertension. The odds ratios (ORs) (95% confidence intervals (CIs)) of participants with sleep quality of 3-, 6-, ≥9 were 1.16(1.07-1.26), 1.35(1.21-1.50) and 1.62 (1.39-1.88) compared to the participants with a score of less than 3 among participants excluding undiagnosed hypertension. ORs and 95% CIs per 3 increment score were higher for hypertension (1.16, 1.11-1.21) among total population, (1.18, 1.10-1.27) among men and (1.13, 1.08-1.19) among women. Compared to reference, poor sleep quality was associated with a higher odd of hypertension (OR 1.09, 95% CI 1.01-1.17) for total population, (1.14, 1.00-1.30) for men and (1.04, 0.95-1.13) for women. Moreover, the odds of hypertension were increased with increment of PSQI score after fitting restricted cubic splines (P <0.01). The meta-analysis showed that pooled OR of hypertension was significantly higher for poor sleepers (1.62, 1.03-2.56, I = 97.3%, P < 0.001).
Higher PSQI score was associated with increased odds of prevalent hypertension in both genders. In addition, poorer sleepers might suffer from hypertension.
本研究旨在探讨睡眠质量差与高血压之间的关联，并评估匹兹堡睡眠质量指数（PSQI）评分与血压和高血压患病率之间的相关性。
本研究共纳入了来自河南农村队列研究的 27912 名年龄在 18-79 岁的参与者。PSQI 评分分为<3、3-、6-、≥9。采用多变量 logistic 回归模型和以高血压为因变量的限制立方样条进行分析。采用荟萃分析验证横断面研究结果。
共有 6085 名（21.80%）参与者睡眠质量差，9056 名（32.44%）患有高血压。与 PSQI 评分<3 的参与者相比，睡眠质量为 3-、6-、≥9 的参与者发生高血压的比值比（OR）（95%置信区间（CI））分别为 1.16（1.07-1.26）、1.35（1.21-1.50）和 1.62（1.39-1.88）。在排除未诊断的高血压患者后，总人群中 PSQI 评分每增加 3 分，高血压的 OR 和 95%CI 更高（1.16，1.11-1.21），男性为 1.18（1.10-1.27），女性为 1.13（1.08-1.19）。与参考组相比，睡眠质量差与高血压的发生风险增加相关（总人群 OR 1.09，95%CI 1.01-1.17），男性为 1.14（1.00-1.30），女性为 1.04（0.95-1.13）。此外，拟合限制立方样条后，PSQI 评分的增加与高血压的发生风险呈正相关（P<0.01）。荟萃分析显示，睡眠质量差的参与者患高血压的风险明显更高（1.62，1.03-2.56，I=97.3%，P<0.001）。
较高的 PSQI 评分与两性高血压患病率的增加有关。此外，睡眠质量差的人可能患有高血压。
