Sleep and future cardiovascular risk: prospective analysis from the English Longitudinal Study of Ageing.
OBJECTIVE
Hypertension and inflammation may contribute to the increased risk of cardiovascular disease in individuals with suboptimal sleep, but large prospective studies are lacking. This study tested whether sleep duration and disturbance were predictive of incident hypertension and inflammation four years later.


METHODS
Participants were men and women aged 50 years and older from the English Longitudinal Study of Ageing. Sleep was assessed by self-report, incident hypertension (N = 3068) was defined by clinical examination and C-reactive protein and fibrinogen (N = 3768) were measures of inflammation.


RESULTS
Both men (odds ratio, OR:1.73, confidence interval, C.I. 1.08-2.76) and women (OR: 1.44, C.I. 1.00-2.07) reporting short sleep at baseline had increased odds of incident hypertension 4 years later, after adjustment for covariates. Age-stratified analyses revealed that short sleep was predictive of incident hypertension in men (OR: 2.27, C.I. 1.01-5.11) and women (OR: 2.10, C.I. 1.08-4.09) younger than 60 years but not in older people. Disturbed sleep also predicted incident hypertension in men (OR: 1.20, C.I. 1.02-1.41). In women, disturbed sleep was associated with elevated C-reactive protein (B = 0.030, C.I. 0.00-0.06) and fibrinogen (B = 0.030, C.I. 0.01-0.05) at follow-up controlling for baseline inflammation and other covariates. Sleep duration was unrelated to inflammatory markers in either sex.


CONCLUSIONS
This study of older men and women adds to growing evidence that aberrant sleep patterns may increase the risk of cardiovascular outcomes through its adverse impact on blood pressure and inflammation.
Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK; Department of Psychology, Whitelands College, University of Roehampton, Holybourne Avenue, London SW15 4JD, UK. Electronic address: marta.jackowska@roehampton.ac.uk.
Marta
M
Jackowska
Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
Andrew
A
Steptoe
D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D004739:England; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology*; D015994:Incidence; D007249:Inflammation / Q000097:blood / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000097:blood / Q000453:epidemiology*
D005340:Fibrinogen; D002097:C-Reactive Protein
C-reactive protein; Fibrinogen; Hypertension; Longitudinal; Sleep disturbance; Sleep duration