Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA.
Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA.
J Sleep Res. 2023 Oct;32(5):e13854. doi: 10.1111/jsr.13854. Epub 2023 Feb 20.
People with disrupted circadian rhythms, such as shift workers, have shown a higher risk of hypertension. However, it is unclear whether more subtle differences in diurnal rest-activity rhythms in the population are associated with hypertension. Clarifying the association between the rest-activity rhythm, a modifiable behavioural factor, and hypertension could provide insight into preventing hypertension and possibly cardiovascular diseases. In this study, we investigated the association between rest-activity rhythm characteristics and hypertension in a large representative sample of United States adults. Cross-sectional data were obtained from the National Health and Nutrition Examination Survey 2011-2014 (N = 6726; mean [range] age 49 [20-79] years; 52% women). Five rest-activity rhythm parameters (i.e., pseudo F statistic, amplitude, mesor, amplitude:mesor ratio, and acrophase) were derived from 24-h actigraphy data using the extended cosine model. We performed multiple logistic regression to assess the associations between the rest-activity rhythm parameters and hypertension. Subgroup analysis stratified by age, gender, race/ethnicity, body mass index and diabetes status was also conducted. A weakened overall rest-activity rhythm, characterised by a lower F statistic, was associated with higher odds of hypertension (odds ratio quintile 1 versus quintile 5 [OR ] 1.61, 95% confidence interval [CI] 1.26-2.05; p trend < 0.001). Similar results were found for lower amplitude (OR 1.51, 95% CI 1.13-2.03; p trend = 0.01) and amplitude:mesor ratio (OR 1.34, 95% CI 1.01-1.78; p trend = 0.03). The results were robust to the adjustment of confounders, individual behaviours including physical activity levels and sleep duration and appeared consistent across subgroups. Possible interaction between the rest-activity rhythm and body mass index was found. Our results support an association between weakened rest-activity rhythms and higher odds of hypertension.
昼夜节律紊乱的人，如轮班工人，高血压风险较高。然而，目前尚不清楚人群中昼夜休息-活动节律的更细微差异是否与高血压有关。阐明休息-活动节律（一种可改变的行为因素）与高血压之间的关联，可以深入了解预防高血压和可能的心血管疾病。在这项研究中，我们调查了美国成年人的一个大型代表性样本中休息-活动节律特征与高血压之间的关联。横断面数据来自 2011-2014 年国家健康和营养检查调查（N=6726；平均[范围]年龄 49[20-79]岁；52%为女性）。使用扩展余弦模型从 24 小时活动记录仪数据中得出五个休息-活动节律参数（即，伪 F 统计量、振幅、中值、振幅：中值比和顶点）。我们进行了多项逻辑回归分析，以评估休息-活动节律参数与高血压之间的关联。还按年龄、性别、种族/民族、体重指数和糖尿病状况进行了亚组分析。整体休息-活动节律减弱，特征为较低的 F 统计量，与高血压的更高几率相关（五分位 1 与五分位 5 的比值比[OR] 1.61，95%置信区间[CI] 1.26-2.05；p 趋势<0.001）。对于较低的振幅（OR 1.51，95%CI 1.13-2.03；p 趋势=0.01）和振幅：中值比（OR 1.34，95%CI 1.01-1.78；p 趋势=0.03）也发现了类似的结果。结果在调整了混杂因素、包括体力活动水平和睡眠时间在内的个体行为后仍然稳健，并且在亚组中表现一致。休息-活动节律和体重指数之间可能存在交互作用。我们的结果支持休息-活动节律减弱与高血压几率增加之间的关联。
