Department of Neurology, Center for Brain and Mind Health, Yale University School of Medicine, New Haven, CT, United States of America.
Withings Inc., Issy-les-Moulineaux, France.
PLoS One. 2024 Apr 16;19(4):e0301631. doi: 10.1371/journal.pone.0301631. eCollection 2024.
Increased blood pressure variability (BPV) is linked to cardiovascular disease and mortality, yet few modifiable BPV risk factors are known. We aimed to assess the relationship between sleep quality and activity level on longitudinal BPV in a cohort of community-dwelling adults (age ≥18) from 17 countries. Using Withings home measurement devices, we examined sleep quality and physical activity over one year, operationalized as mean daily step count and number of sleep interruptions, both transformed into tertiles. The primary study outcome was high BPV, defined as the top tertile of systolic blood pressure standard deviation. Our cohort comprised 29,375 individuals (mean age = 58.6 years) with 127.8±90.1 mean days of measurements. After adjusting for age, gender, country, body mass index, measurement days, mean blood pressure, and total time in bed, the odds ratio of having high BPV for those in the top tertile of sleep interruptions (poor sleep) was 1.37 (95% CI, 1.28-1.47) and 1.44 (95% CI, 1.35-1.54) for those in the lowest tertile of step count (physically inactive). Combining these exposures revealed a significant excess relative risk of 0.20 (95% CI, 0.04-0.35, p = 0.012), confirming their super-additive effect. Comparing individuals with the worst exposure status (lowest step count and highest sleep interruptions, n = 2,690) to those with the most optimal status (highest step count and lowest sleep interruptions, n = 3,531) yielded an odds ratio of 2.01 (95% CI, 1.80-2.25) for high BPV. Our findings demonstrate that poor sleep quality and physical inactivity are associated with increased BPV both independently and super-additively.
血压变异性（BPV）增加与心血管疾病和死亡率有关，但已知的可改变的 BPV 风险因素很少。我们旨在评估睡眠质量和活动水平与来自 17 个国家的社区居住成年人（年龄≥18 岁）的纵向 BPV 之间的关系。使用 Withings 家庭测量设备，我们在一年中检查了睡眠质量和身体活动，将平均每日步数和睡眠中断次数都转化为三分位数来表示。主要研究结果是高 BPV，定义为收缩压标准差的最高三分位数。我们的队列包括 29375 名个体（平均年龄=58.6 岁），平均测量天数为 127.8±90.1 天。在调整年龄、性别、国家、体重指数、测量天数、平均血压和总卧床时间后，睡眠中断（睡眠质量差）最高三分位的个体发生高 BPV 的比值比为 1.37（95%可信区间，1.28-1.47），而最低三分位的个体发生高 BPV 的比值比为 1.44（95%可信区间，1.35-1.54）。对于那些活动量最低（身体不活跃）的个体来说。结合这些暴露因素，发现相对超额风险为 0.20（95%可信区间，0.04-0.35，p=0.012），证实了它们的超相加效应。将暴露状况最差的个体（最低步数和最高睡眠中断，n=2690）与暴露状况最佳的个体（最高步数和最低睡眠中断，n=3531）进行比较，高 BPV 的比值比为 2.01（95%可信区间，1.80-2.25）。我们的研究结果表明，睡眠质量差和身体不活动与独立和超相加的 BPV 增加有关。
