|
Nursing Science 2025
中国中老年人睡眠时长与高血压的关联性研究
|
Abstract:
目的:了解我国中老年人高血压患病现状,探讨中老年人睡眠时长与高血压患病的关系。方法:数据来源于北京大学中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS),使用频数和百分比对高血压进行一般统计描述,采用二元logistic回归和限制性立方样条图探讨睡眠时长与高血压患病的相关关系和非线性关系。结果:本研究纳入有效样本19,558人,高血压患病率、睡眠时长不足率、睡眠时长过度率分别为38.47% (7524/19,558)、56.35% (11,020/19,558)、9.44% (1847/19,558)。控制混杂因素后,相较于睡眠时长为7~8 h,睡眠时长 < 7 h (OR = 1.12)和睡眠时长 > 8 h (OR = 1.21)与高血压发生存在关联。限制性立方样条图结果显示,睡眠时长7.12 h为临界点,睡眠时长 < 6 h和>8.24 h与高血压患病风险升高相关。结论:在中老年人群中,睡眠时长小于7 h和大于8 h均可能是高血压患病的危险因素,而睡眠过多的风险略高于睡眠不足,睡眠时长与高血压呈“U”形关系。
Objective: To determine the prevalence of hypertension among middle-aged and older adults in China and explore the relationship between sleep duration and hypertension among middle-aged and older adults. Methods: Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) at Peking University. Frequencies and percentages were used to describe the general statistics of hypertension. Binary logistic regression and constrained cubic splines were used to examine the correlation and nonlinear relationship between sleep duration and hypertension. Result: The study included a valid sample of 19,558 participants, and the prevalence of hypertension, sleep duration insufficiency, and sleep duration excess was 38.47% (7524/19,558), 56.35% (11,020/19,558), and 9.44% (1847/19,558), respectively. After controlling for confounders, less than 7 hours of sleep (OR = 1.12) and more than 8 hours of sleep (OR = 1.21) were associated with hypertension compared to 7~8 hours of sleep. A restricted cubic plot showed that 7.12 hours of sleep was the threshold, with less than 6 hours of sleep and more than 8.24 hours of sleep being associated with an increased risk of hypertension. Conclusion: In middle-aged and older adults, sleep duration of less than 7 hours and more than 8 hours may be risk factors for hypertension, but the risk of sleeping too long is somewhat higher than the risk of sleeping too short, and the relationship between sleep duration and hypertension is U-shaped.
[1] | 胡盛寿, 王增武. 《中国心血管健康与疾病报告2022》概述[J]. 中国心血管病研究, 2023, 21(7): 577-600. |
[2] | Essien, S.K., Feng, C.X., Sun, W., Farag, M., Li, L. and Gao, Y. (2018) Sleep Duration and Sleep Disturbances in Association with Falls among the Middle-Aged and Older Adults in China: A Population-Based Nationwide Study. BMC Geriatrics, 18, Article No. 196. https://doi.org/10.1186/s12877-018-0889-x |
[3] | Khan, M.S. and Aouad, R. (2017) The Effects of Insomnia and Sleep Loss on Cardiovascular Disease. Sleep Medicine Clinics, 12, 167-177. https://doi.org/10.1016/j.jsmc.2017.01.005 |
[4] | 中华人民共和国国家卫生健康委员会医政司. 肥胖症中国诊疗指南(2024年版) [J]. 协和医学杂志, 2024: 1-60. |
[5] | Lv, W., Finlayson, G. and Dando, R. (2018) Sleep, Food Cravings and Taste. Appetite, 125, 210-216. https://doi.org/10.1016/j.appet.2018.02.013 |
[6] | 成人高血压食养指南(2023年版) [J]. 全科医学临床与教育, 2023, 21(6): 484-485, 507. |
[7] | 中国心血管健康与疾病报告2023概要[J]. 中国循环杂志, 2024, 39(7): 625-660. |
[8] | Guo, J., Fei, Y., Li, J., Zhang, L., Luo, Q. and Chen, G. (2016) Gender-and Age-Specific Associations between Sleep Duration and Prevalent Hypertension in Middle-Aged and Elderly Chinese: A Cross-Sectional Study from CHARLS 2011-2012. BMJ Open, 6, e011770. https://doi.org/10.1136/bmjopen-2016-011770 |
[9] | Ziegler, M.G. (2003) Sleep Disorders and the Failure to Lower Nocturnal Blood Pressure. Current Opinion in Nephrology and Hypertension, 12, 97-102. https://doi.org/10.1097/00041552-200301000-00016 |
[10] | Goodfriend, T.L. and Calhoun, D.A. (2004) Resistant Hypertension, Obesity, Sleep Apnea, and Aldosterone: Theory and Therapy. Hypertension, 43, 518-524. https://doi.org/10.1161/01.hyp.0000116223.97436.e5 |
[11] | Rodenbeck, A., Cohrs, S., Jordan, W., Huether, G., Rüther, E. and Hajak, G. (2003) The Sleep-Improving Effects of Doxepin Are Paralleled by a Normalized Plasma Cortisol Secretion in Primary Insomnia. A Placebo-Controlled, Double-Blind, Randomized, Cross-Over Study Followed by an Open Treatment over 3 Weeks. Psychopharmacology, 170, 423-428. https://doi.org/10.1007/s00213-003-1565-0 |
[12] | 骆诗韵, 叶咏欣, 孙敏英, 等. 广州市30-79岁成年居民睡眠质量和睡眠时间与高血压患病的关联研究[J]. 中华预防医学杂志, 2021, 55(7): 853-859. |
[13] | Wang, C., Wang, B., Liu, D., Zhang, Y., Zheng, Y., Guo, L., et al. (2022) Self-Reported Sleep-Disordered Breathing and Insomnia in Association with Hypertension: A Community-Based Study in Eastern China. Blood Pressure Monitoring, 27, 320-326. https://doi.org/10.1097/mbp.0000000000000609 |
[14] | 关云琦, 梁明斌, 潘劲, 等. 浙江省成年人睡眠时间与高血压的关联研究[J]. 预防医学, 2022, 34(7): 681-686. |
[15] | Wang, H., Zee, P., Reid, K., Chervin, R.D., Patwari, P.P., Wang, B., et al. (2011) Gender-Specific Association of Sleep Duration with Blood Pressure in Rural Chinese Adults. Sleep Medicine, 12, 693-699. https://doi.org/10.1016/j.sleep.2010.12.019 |
[16] | Fietze, I., Laharnar, N., Obst, A., Ewert, R., Felix, S.B., Garcia, C., et al. (2018) Prevalence and Association Analysis of Obstructive Sleep Apnea with Gender and Age Differences—Results of Ship‐Trend. Journal of Sleep Research, 28, e12770. https://doi.org/10.1111/jsr.12770 |
[17] | Wang, C., Xu, J., Yang, L., Xu, Y., Zhang, X., Bai, C., et al. (2018) Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease in China (the China Pulmonary Health [CPH] Study): A National Cross-Sectional Study. The Lancet, 391, 1706-1717. https://doi.org/10.1016/s0140-6736(18)30841-9 |
[18] | Oishi, M., Suwazono, Y., Sakata, K., Okubo, Y., Harada, H., Kobayashi, E., et al. (2005) A Longitudinal Study on the Relationship between Shift Work and the Progression of Hypertension in Male Japanese Workers. Journal of Hypertension, 23, 2173-2178. https://doi.org/10.1097/01.hjh.0000189870.55914.b3 |