The association of actigraphy-assessed sleep duration with sleep blood pressure, nocturnal hypertension, and nondipping blood pressure: the coronary artery risk development in young adults (CARDIA) study : Journal of Hypertension

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The association of actigraphy-assessed sleep duration with sleep blood pressure, nocturnal hypertension, and nondipping blood pressure: the coronary artery risk development in young adults (CARDIA) study

Abdalla, Marwaha; Sakhuja, Swatib; Akinyelure, Oluwasegun P.b; Thomas, S. Justinc; Schwartz, Joseph E.a,d; Lewis, Cora E.b; Shikany, James M.e; Lloyd-Jones, Donaldf; Booth, John N. IIIb,g; Shimbo, Daichia; Hall, Martica H.h; Muntner, Paulb

Author Information

aDepartment of Medicine, Columbia University Irving Medical Center, New York, New York

bDepartment of Epidemiology

cDepartment of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama

dDepartment of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York

eDepartment of Medicine, University of Alabama at Birmingham, Birmingham, Alabama

fDepartment of Preventive Medicine, Northwestern University, Chicago, Illinois

gCTI Clinical Trials and Consulting Services, Inc., Covington, Kentucky

hDepartment of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

Correspondence to Marwah Abdalla, MD, MPH, Center for Behavioral Cardiovascular Health, 622 West 168th Street, PH 9-301, Columbia University Irving Medical Center, New York, NY 10032, USA. Tel: +1 212 342 1275; e-mail: [email protected]

Abbreviations: ABPM, ambulatory blood pressure monitoring; ACR, albumin-to-creatinine ratio; BP, blood pressure; CARDIA, Coronary Artery Risk Development in Young Adults; CES-D, Center for Epidemiologic Studies Depression; CVD, cardiovascular disease; eGFR, estimated glomerular filtration rate; LSD, long sleep duration; NSD, normal sleep duration; OSA, obstructive sleep apnea; PR, prevalence ratio; SSD, short sleep duration

Received 19 January, 2021

Revised 21 June, 2021

Accepted 25 June, 2021

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://www.jhypertension.com).

Journal of Hypertension 39(12):p 2478-2487, December 2021. | DOI: 10.1097/HJH.0000000000002956

Abstract

Objective: 

Nocturnal hypertension and nondipping systolic blood pressure (SBP) are associated with increased cardiovascular disease (CVD) risk. Short and long sleep duration (SSD and LSD) are also associated with increased CVD risk and may be risk factors for nocturnal hypertension and nondipping SBP. We examined the association between SSD and LSD with sleep BP, nocturnal hypertension, and nondipping SBP among 647 white and African American Coronary Artery Risk Development in Young Adults (CARDIA) study participants who completed 24-h ambulatory BP monitoring, wrist actigraphy, and sleep diaries in 2015–2016.

Methods: 

The times when participants were asleep and awake were determined from actigraphy complemented by sleep diaries. Nocturnal hypertension was defined as sleep BP ≥120/70 mmHg and nondipping SBP as mean sleep-to-awake SBP ratio >0.90. Sleep duration was categorized as SSD (<6 h), normal sleep duration (NSD: 6–8.9 h), and LSD (≥9 h).

Results: 

The prevalence of SSD and LSD were 13.9 and 21.1%, respectively. Compared to participants with NSD, participants with LSD had higher mean sleep SBP (2.1 mmHg, 95% confidence interval [CI] 0.2, 4.1 mmHg) and diastolic BP (1.7 mmHg, 95% CI 0.5, 3.0 mmHg). Participants with LSD had a higher prevalence of nocturnal hypertension (prevalence ratio [PR]: 1.26, 95% CI 1.03–1.54) and nondipping SBP (PR 1.33, 95% CI 1.03–1.72) compared to participants with NSD. There was no evidence of an association between SSD and sleep SBP or DBP, nocturnal hypertension, or nondipping SBP.

Conclusions: 

These findings suggest that LSD may be associated with nocturnal hypertension and nondipping SBP.

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