睡眠障碍杂志：治疗和护理

Resistant Hypertension and Sleep Duration among Blacks with Metabolic Syndrome MetSO

April Rogers , Olivia Necola , Azizi Sexias , Alla Luka , Valerie Newsome , Stephen Williams , Samy I McFarlane and Girardin Jean-Louis

Introduction: Resistant hypertension (RHTN) is an important condition affecting 29% of the hypertensive population. Sleep disturbances are increasingly recognized as underlying disorders among patients with RHTN. We evaluated associations of RHTN with short sleep duration among blacks with metabolic syndrome (MetS), a vulnerable population characterized by high prevalence of RHTN.

Methods: Data from the Metabolic Syndrome Outcome Study (MetSO), a NIH-funded cohort study characterizing metabolic syndrome (MetS) among blacks. MetS was defined according to criteria from the Adult Treatment Panel (ATP III). According to the American Heart Association RHTN is defined as blood pressure that remains above goal in spite of the use of 3 antihypertensive drugs of different classes, one of the three prescribed pharmaceutical agents should be a diuretic and all agents prescribed at optimal dose amounts.[1] Short sleep was defined as self-reported sleep durations < 7 hours, referenced to healthy sleep (7-8 hours).

Results: Analysis was based on 1,035 patients (mean age: 62±14years; female: 69.2%), providing complete data. Of the sample, 90.4% were overweight /obese; 61.4% had diabetes; 74.8% had dyslipidemia; 30.2% had a history of heart disease; and 48% were at OSA risk. Overall, 92.6% had hypertension (HTN), and 20.8% met criteria for RHTN. Analyses showed those with RHTN were more likely to be short sleepers (26.8% vs. 14.9%, p< 0.001). Based on logistic regression analysis, adjusting for effects of age, sex, and medical comorbidities, patients with RHTN had increased odds of being short sleepers. (OR=1.90, 95% CI: 1.27- 2.96, p=0.002)

Conclusion: Among blacks with metabolic syndrome, patients meeting criteria for resistant hypertension showed a twofold greater likelihood of being short sleepers. Adjusted odds of short sleep were similar to those observed for patients at OSA risk