Association of sleep trajectory in adulthood with risk of hypertension and its related risk factors: the China Health and Nutrition Survey

Study Objectives: Few studies have examined the association between sleep duration trajectories and hypertension. This study aims to examine association of sleep duration trajectories with risk of hypertension and its related factors. Methods: This study used longitudinal data for 7,397 adults who provided valid responses in questionnaire with regard to information of sleep and hypertension from the China Health and Nutrition Survey (2004-2011). Subgroup analyses included 5,532 participants in whom hypertension-related factors were measured using blood samples. Latent class trajectory analysis was used to identify different sleep duration trajectories. Multivariate Cox regression models and general linear regression models were used to assess association of trajectories with hypertension and its related factors. Results: Compared to stable sleep duration around 8 hours, the trajectory showing a persistent decrease in sleep duration with aging was significantly associated with increased risk of hypertension (hazard ratio 1.12, 95% confidence interval 1.01-1.24), whereas no significant association was observed between the trajectory showing an increase in sleep duration to 9 hours with aging and risk of hypertension (hazard ratio 1.05, 95% confidence interval 0.93-1.19). Further, uric acid levels, fasting glucose levels, total cholesterol levels, and apolipoprotein B levels were significantly higher in the trajectory showing a persistent decrease in sleep duration with aging than the other two trajectories (all P < .05). Conclusions: Decreasing sleep duration during aging is significantly associated with increased risk of hypertension and higher levels of its biomarkers throughout adulthood.