title: Gender-specific associations of short sleep duration with prevalent and incident hypertension: the Whitehall II Study.
abstract: Sleep deprivation (<or=5 hour per night) was associated with a higher risk of hypertension in middle-aged American adults but not among older individuals. However, the outcome was based on self-reported diagnosis of incident hypertension, and no gender-specific analyses were included. We examined cross-sectional and prospective associations of sleep duration with prevalent and incident hypertension in a cohort of 10,308 British civil servants aged 35 to 55 years at baseline (phase 1: 1985-1988). Data were gathered from phase 5 (1997-1999) and phase 7 (2003-2004). Sleep duration and other covariates were assessed at phase 5. At both examinations, hypertension was defined as blood pressure >or=140/90 mm Hg or regular use of antihypertensive medications. In cross-sectional analyses at phase 5 (n=5766), short duration of sleep (<or=5 hour per night) was associated with higher risk of hypertension compared with the group sleeping 7 hours, among women (odds ratio: 1.72[corrected]; 95% CI: 1.07[corrected] to 2.75[corrected]), independent of confounders, with an inverse linear trend across decreasing hours of sleep (P=0.037[corrected]). No association was detected in men. In prospective analyses (mean follow-up: 5 years), the cumulative incidence of hypertension was 20.0% (n=740) among 3691 normotensive individuals at phase 5. In women, short duration of sleep was associated with a higher risk of hypertension in a reduced model (age and employment) (6 hours per night: odds ratio: 1.56 [95% CI: 1.07 to 2.27]; <or=5 hour per night: odds ratio: 1.94 [95% CI: 1.08 to 3.50] versus 7 hours). The associations were attenuated after accounting for cardiovascular risk factors and psychiatric comorbidities (odds ratio: 1.42 [95% CI: 0.94 to 2.16]; odds ratio: 1.31 [95% CI: 0.65 to 2.63], respectively). Sleep deprivation may produce detrimental cardiovascular effects among women.
authors.affiliation: Clinical Sciences Research Institute, Warwick Medical School, Coventry, United Kingdom. sleepresearch@warwick.ac.uk
authors.forename: Francesco P
authors.initials: FP
authors.lastname: Cappuccio
authors.forename: Saverio
authors.initials: S
authors.lastname: Stranges
authors.forename: Ngianga-Bakwin
authors.initials: NB
authors.lastname: Kandala
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Miller
authors.forename: Frances M
authors.initials: FM
authors.lastname: Taggart
authors.forename: Meena
authors.initials: M
authors.lastname: Kumari
authors.forename: Jane E
authors.initials: JE
authors.lastname: Ferrie
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Shipley
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Brunner
authors.forename: Michael G
authors.initials: MG
authors.lastname: Marmot
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012727:Sex Characteristics; D012890:Sleep / Q000502:physiology; D012892:Sleep Deprivation