Characterization of insomnia in patients with essential hypertension.
BACKGROUND
Insomnia may increase risk of cardiovascular events. There is little data available reporting the prevalence and clinical relevance of insomnia in patients with essential hypertension. Therefore, the aim of the study was to investigate the relationship between insomnia and different clinical and biochemical parameters in essential hypertension patients.


METHODS
Four hundred and thirty-two patients (mean age 47+/-13 years; 253 male, 179 female) with essential hypertension were screened for insomnia using the athens Insomnia Scale (AIS). Several variables including age, sex, known duration of hypertension, body mass index, creatinine, left ventricular mass index, coexisting disorders, smoking status and alcohol use were analysed. Twenty-four-hour ambulatory blood pressure measurements (ABPM) were performed.


RESULTS
Among patients included in the study, 207 subjects (mean age: 49+/-13 years; 47.9%) had an AIS score of 15 or higher and were identified as insomniacs. Insomnia was more frequent in women than in men (60.9% vs 38.7%, p<0.001) and was reported more frequently in patients with coronary artery disease. Subjects with insomnia were older and had longer duration of hypertension. There were no differences between insomniacs and non-insomniacs in ABPM parameters. A relationship was found between the number of antihypertensive drugs and insomnia frequency. There were correlation between AIS score and age (r=0.21; p<0.001) and duration of hypertension (r=0.22; p<0.001). In the sub-group of untreated essential hypertension patients, there were negative correlations between AIS score and night fall in systolic and diastolic blood pressure.


CONCLUSIONS
Our results showed that insomnia is common in patients with essential hypertension and indicate an association between insomnia and gender, known duration of hypertension and number of hypertensive drugs taken. Untreated essential hypertension insomniacs were characterized by less pronounced nocturnal fall in both systolic and diastolic blood pressure compared with non-insomniacs.
Prejbisz
Aleksander
A
Department o Hypertension, Institute of Cardiology, Warsaw, Poland. prejbisz@vp.pl
Kabat
Marek
M
Januszewicz
Andrzej
A
Szelenberger
Waldemar
W
Piotrowska
Anna J
AJ
Piotrowski
Walerian
W
Piwoński
Jerzy
J
Makowiecka-Cieśla
Magdalena
M
Widecka
Krystyna
K
Patera
Bozena
B
Bieniaszewski
Leszek
L
Narkiewicz
Krzysytof
K
Tykarski
Andrzej
A
Piejko
Anna
A
Grodzicki
Tomasz
T
Czerwieńska
Beata
B
Wiecek
Andrzej
A
D000328:Adult; D000367:Age Factors; D000959:Antihypertensive Agents / Q000009:adverse effects; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012737:Sex Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology
D000959:Antihypertensive Agents