Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Age- and gender-specific associations between sleep duration and incident hypertension in a Chinese population: the Kailuan study

Abstract

The objective of this study was to explore the age- and sex-dependent association between sleep duration and incident hypertension in a Chinese population. The Kailuan prospective cohort study recruited 101 510 participants. Those participants were followed for an average of 3.98 years and the data obtained from 32 137 participants out of 101 510 were analyzed in this study. Sleep duration was categorized as five groups of5, 6, 7, 8 and 9 h. Cox proportional-hazards models were used to analyze the association of sleep duration with incident hypertension. The 3.98 years’ follow-up data showed that 12 732 out of 32 137 participants developed hypertension. Short duration of sleep (5 h per night) was associated with an increased risk of hypertension in woman (hazard ratio (HR) 1.27; 95% confidence interval (CI) 1.02 to 1.58) and participants aged <60 years (HR 1.11; 95% CI 1.02–1.21), when compared with the group reported with 7 h of sleep per day. This study suggested that short sleep duration could cause an increased risk of hypertension in Chinese females and population aged <60 years.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Hajjar I, Kotchen TA . Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA 2003; 290 (2): 199–206.

    Article  Google Scholar 

  2. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42 (6): 1206–1252.

    Article  CAS  Google Scholar 

  3. Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ . Selected major risk factors and global and regional burden of disease. Lancet 2002; 360 (9343): 1347–1360.

    Article  Google Scholar 

  4. Lawes CM, Vander Hoorn S, Rodgers A . Global burden of blood-pressure-related disease, 2001. Lancet 2008; 371 (9623): 1513–1518.

    Article  Google Scholar 

  5. Wolk R, Gami AS, Garcia-Touchard A, Somers VK . Sleep and cardiovascular disease. Curr Prob Cardiol 2005; 30 (12): 625–662.

    Article  Google Scholar 

  6. Ayas NT, White DP, Al-Delaimy WK, Manson JE, Stampfer MJ, Speizer FE et al. A prospective study of self-reported sleep duration and incident diabetes in women. Diabetes Care 2003; 26 (2): 380–384.

    Article  Google Scholar 

  7. Gottlieb DJ, Redline S, Nieto FJ, Baldwin CM, Newman AB, Resnick HE et al. Association of usual sleep duration with hypertension: the Sleep Heart Health Study. Sleep 2006; 29 (8): 1009–1014.

    Article  Google Scholar 

  8. Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Pickering TG et al. Short sleep duration as a risk factor for hypertension: analyses of the first National Health and Nutrition Examination Survey. Hypertension 2006; 47 (5): 833–839.

    Article  CAS  Google Scholar 

  9. Kohatsu ND, Tsai R, Young T, Vangilder R, Burmeister LF, Stromquist AM et al. Sleep duration and body mass index in a rural population. Arch Intern Med 2006; 166 (16): 1701–1705.

    Article  Google Scholar 

  10. Patel SR, Malhotra A, White DP, Gottlieb DJ, Hu FB . Association between reduced sleep and weight gain in women. Am J Epidemiol 2006; 164 (10): 947–954.

    Article  Google Scholar 

  11. Gangwisch JE, Malaspina D, Boden-Albala B, Heymsfield SB . Inadequate sleep as a risk factor for obesity: analyses of the NHANES I. Sleep 2005; 28 (10): 1289–1296.

    Article  Google Scholar 

  12. Patel SR, Ayas NT, Malhotra MR, White DP, Schernhammer ES, Speizer FE et al. A prospective study of sleep duration and mortality risk in women. Sleep 2004; 27 (3): 440–444.

    Article  Google Scholar 

  13. Lusardi P, Mugellini A, Preti P, Zoppi A, Derosa G, Fogari R . Effects of a restricted sleep regimen on ambulatory blood pressure monitoring in normotensive subjects. Am J Hypertens 1996; 9 (5): 503–505.

    Article  CAS  Google Scholar 

  14. Kato M, Phillips BG, Sigurdsson G, Narkiewicz K, Pesek CA, Somers VK . Effects of sleep deprivation on neural circulatory control. Hypertension 2000; 35 (5): 1173–1175.

    Article  CAS  Google Scholar 

  15. Meier-Ewert HK, Ridker PM, Rifai N, Regan MM, Price NJ, Dinges DF et al. Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol 2004; 43 (4): 678–683.

    Article  CAS  Google Scholar 

  16. Lusardi P, Zoppi A, Preti P, Pesce RM, Piazza E, Fogari R . Effects of insufficient sleep on blood pressure in hypertensive patients: a 24- h study. Am J Hypertens 1999; 12 (1 Pt 1): 63–68.

    Article  CAS  Google Scholar 

  17. Azadbakht L, Kelishadi R, Khodarahmi M, Qorbani M, Heshmat R, Motlagh ME et al. The association of sleep duration and cardiometabolic risk factors in a national sample of children and adolescents: the CASPIAN III study. Nutrition 2013; 29 (9): 1133–1141.

    Article  Google Scholar 

  18. Javaheri S, Storfer-Isser A, Rosen CL, Redline S . Sleep quality and elevated blood pressure in adolescents. Circulation 2008; 118 (10): 1034–1040.

    Article  Google Scholar 

  19. Paciencia I, Barros H, Araujo J, Ramos E . Association between sleep duration and blood pressure in adolescents. Hypertens Res 2013; 36 (8): 747–752.

    Article  Google Scholar 

  20. Guo X, Zheng L, Li Y, Yu S, Liu S, Zhou X et al. Association between sleep duration and hypertension among Chinese children and adolescents. Clin Cardiol 2011; 34 (12): 774–781.

    Article  Google Scholar 

  21. Cappuccio FP, Stranges S, Kandala NB, Miller MA, Taggart FM, Kumari M et al. Gender-specific associations of short sleep duration with prevalent and incident hypertension: the Whitehall II Study. Hypertension 2007; 50 (4): 693–700.

    Article  CAS  Google Scholar 

  22. Kim SJ, Lee SK, Kim SH, Yun CH, Kim JH, Thomas RJ et al. Genetic association of short sleep duration with hypertension incidence—a 6-year follow-up in the Korean genome and epidemiology study. Circulation J 2012; 76 (4): 907–913.

    Article  Google Scholar 

  23. Wang A, Liu X, Guo X, Dong Y, Wu Y, Huang Z et al. Resting heart rate and risk of hypertension: results of the Kailuan cohort study. J Hypertens 2014; 32 (8): 1600–1605 Discussion 5.

    Article  CAS  Google Scholar 

  24. Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Opler MG et al. Sleep duration associated with mortality in elderly, but not middle-aged, adults in a large US sample. Sleep 2008; 31 (8): 1087–1096.

    PubMed  PubMed Central  Google Scholar 

  25. Haas DC, Foster GL, Nieto FJ, Redline S, Resnick HE, Robbins JA et al. Age-dependent associations between sleep-disordered breathing and hypertension: importance of discriminating between systolic/diastolic hypertension and isolated systolic hypertension in the Sleep Heart Health Study. Circulation 2005; 111 (5): 614–621.

    Article  Google Scholar 

  26. Prinz PN . Age impairments in sleep, metabolic and immune functions. Exp Gerontol 2004; 39 (11-12): 1739–1743.

    Article  CAS  Google Scholar 

  27. Martinez-Garcia MA, Campos-Rodriguez F, Catalan-Serra P, Soler-Cataluna JJ, Almeida-Gonzalez C, De la Cruz Moron I et al. Cardiovascular mortality in obstructive sleep apnea in the elderly: role of long-term continuous positive airway pressure treatment: a prospective observational study. Am J Respir Crit Care Med 2012; 186 (9): 909–916.

    Article  Google Scholar 

  28. Stranges S, Dorn JM, Cappuccio FP, Donahue RP, Rafalson LB, Hovey KM et al. A population-based study of reduced sleep duration and hypertension: the strongest association may be in premenopausal women. J Hypertens 2010; 28 (5): 896–902.

    Article  CAS  Google Scholar 

  29. Spiegel K, Leproult R, Van Cauter E . Impact of sleep debt on metabolic and endocrine function. Lancet 1999; 354 (9188): 1435–1439.

    Article  CAS  Google Scholar 

  30. Spiegel K, Tasali E, Penev P, Van Cauter E . Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 2004; 141 (11): 846–850.

    Article  Google Scholar 

  31. Yan YX, Dong J, Wu LJ, Shao S, Zhang J, Zhang L et al. Associations between polymorphisms in the glucocorticoid-receptor gene and cardiovascular risk factors in a Chinese population. J Epidemiol 2013; 23 (5): 389–395.

    Article  Google Scholar 

  32. Yan YX, Dong J, Liu YQ, Zhang J, Song MS, He Y et al. Association of suboptimal health status with psychosocial stress, plasma cortisol and mRNA expression of glucocorticoid receptor alpha/beta in lymphocyte. Stress 2015; 18 (1): 29–34.

    Article  CAS  Google Scholar 

  33. Gao J, Sun H, Liang X, Gao M, Zhao H, Qi Y et al. Ideal cardiovascular health behaviors and factors prevent the development of hypertension in prehypertensive subjects. Clin Exp Hypertens 2015; 37: 1–6.

    Article  Google Scholar 

  34. Li Z, Yang X, Wang A, Qiu J, Wang W, Song Q et al. Association between ideal cardiovascular health metrics and depression in Chinese population: a cross-sectional study. Sci Rep 2015; 5: 11564.

    Article  CAS  Google Scholar 

  35. Kario K . Obstructive sleep apnea syndrome and hypertension: mechanism of the linkage and 24- h blood pressure control. Hypertens Res 2009; 32 (7): 537–541.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank all study participants, their relatives, the members of the survey teams at the 11 regional hospitals of the Kailuan Medical Group, and the project development and management teams at the Beijing Tiantan hospital and the Kailuan Group.

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to X Wang or S Wu.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Song, Q., Liu, X., Wang, X. et al. Age- and gender-specific associations between sleep duration and incident hypertension in a Chinese population: the Kailuan study. J Hum Hypertens 30, 503–507 (2016). https://doi.org/10.1038/jhh.2015.118

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2015.118

This article is cited by

Search

Quick links