Dataset Information

Association of sleep trajectory in adulthood with risk of hypertension and its related risk factors: the China Health and Nutrition Survey.

ABSTRACT:

Study objectives

Few studies have examined the association between sleep duration trajectories and hypertension. This study aims to examine association of sleep duration trajectories with risk of hypertension and its related factors.

Methods

This study used longitudinal data for 7,397 adults who provided valid responses in questionnaire with regard to information of sleep and hypertension from the China Health and Nutrition Survey (2004-2011). Subgroup analyses included 5,532 participants in whom hypertension-related factors were measured using blood samples. Latent class trajectory analysis was used to identify different sleep duration trajectories. Multivariate Cox regression models and general linear regression models were used to assess association of trajectories with hypertension and its related factors.

Results

Compared to stable sleep duration around 8 hours, the trajectory showing a persistent decrease in sleep duration with aging was significantly associated with increased risk of hypertension (hazard ratio 1.12, 95% confidence interval 1.01-1.24), whereas no significant association was observed between the trajectory showing an increase in sleep duration to 9 hours with aging and risk of hypertension (hazard ratio 1.05, 95% confidence interval 0.93-1.19). Further, uric acid levels, fasting glucose levels, total cholesterol levels, and apolipoprotein B levels were significantly higher in the trajectory showing a persistent decrease in sleep duration with aging than the other two trajectories (all P < .05).

Conclusions

Decreasing sleep duration during aging is significantly associated with increased risk of hypertension and higher levels of its biomarkers throughout adulthood.

SUBMITTER: Wang Y

PROVIDER: S-EPMC7161444 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectiveThis longitudinal study aims to identify distinct trajectories of body mass index (BMI) and waist circumference (WC) during 20-60 years old, and explore their joint effect on incident hypertension.DesignA longitudinal cohort study.SettingChina Health and Nutrition Survey, 1993-2011.ParticipantsThe longitudinal cohort included 6571 participants (3063 men) who had BMI and WC repeatedly measured 3-7 times before incident hypertension or loss to follow-up.OutcomesHypertension was defined as systolic blood pressure/diastolic blood pressure>140/90 mm Hg or diagnosis by medical records or taking antihypertensive medication.ResultsTwo distinct trajectories were characterised for both BMI and WC: low-increasing and high-increasing. Jointly, subjects were divided into four groups: normal (n=4963), WC-increasing (n=620), BMI-increasing (n=309) and BMI&WC-increasing (n=679). Compared with the normal group, the adjusted HRs and 95% CIs for hypertension were 1.43 (1.19 to 1.74), 1.51 (1.19 to 1.92) and 1.76 (1.45 to 2.14) for WC-increasing, BMI-increasing and BMI&WC-increasing groups, respectively. The model-estimated levels and slopes of BMI and WC were calculated at each age point in 1-year interval according to the model parameters and their first derivatives, respectively. The associations between model-estimated levels and hypertension increased with age, with adjusted ORs and 95% CIs ranging from 0.92 (0.86 to 0.98) to 1.57 (1.47 to 1.67) for BMI and 0.98 (0.92 to 1.05) to 1.44 (1.35 to 1.53) for WC. Conversely, the ORs (95% CIs) of level-adjusted linear slopes decreased with age, ranging from 1.47 (1.38 to 1.57) to 0.97 (0.92 to 1.03) for BMI and 1.36 (1.28 to 1.45) to 0.99 (0.93 to 1.06) for WC.ConclusionsOur study demonstrates that the joint trajectories of BMI and WC have significant effect on future hypertension risk, and the changing slopes of BMI and WC during young adulthood are independent risk factors. Both BMI and WC should be paid more attention to prevent hypertension, and young adulthood may be a crucial period for intervention.