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Wu DF, Yin RX, Deng JL. Homocysteine, hyperhomocysteinemia, and H-type hypertension. Eur J Prev Cardiol 2024; 31:1092-1103. [PMID: 38236144 DOI: 10.1093/eurjpc/zwae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/10/2024] [Accepted: 01/13/2024] [Indexed: 01/19/2024]
Abstract
Homocysteine (Hcy) is a sulphur-containing nonessential amino acid derived from the intermediate metabolites of methionine. Methionine is obtained from dietary proteins, such as poultry, meat, eggs, seafood, and dairy products. Abnormalities in Hcy metabolic pathways, deficiencies in dietary methionine, folate, and vitamins B12, B6, and B2 and genetic defects, polymorphisms, or mutations in Hcy metabolism-related enzymes may lead to an increase in plasma Hcy levels. Generally, a plasma Hcy level higher than 10 or 15 μmol/L has been defined as hyperhomocysteinemia (HHcy). An individual with essential hypertension complicated with HHcy is considered to have H-type hypertension (HTH). Currently, HHcy is considered a novel independent risk factor for various cardiovascular diseases. To provide a useful reference for clinicians, the research progress on Hcy, HHcy, and HTH in recent years was systematically reviewed here, with a focus on the source and metabolic pathways of Hcy, plasma Hcy levels and influencing factors, detection methods for plasma Hcy levels, relationship between Hcy concentration and hypertension, pathogenesis of HTH, cardiovascular complications of HTH, and treatment of HTH.
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Affiliation(s)
- Dong-Feng Wu
- Department of Geriatric Cardiology, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning 530021, Guangxi, People's Republic of China
| | - Rui-Xing Yin
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning 530021, Guangxi, People's Republic of China
| | - Jin-Long Deng
- Department of Geriatric Cardiology, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning 530021, Guangxi, People's Republic of China
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Wang Z, Heizhati M, Wang L, Li M, Yang Z, Lin M, Abudereyimu R, Hong J, Yang W, Yao L, Liu S, Hu J, Li N. Poor sleep quality is negatively associated with low cognitive performance in general population independent of self-reported sleep disordered breathing. BMC Public Health 2022; 22:3. [PMID: 34980052 PMCID: PMC8725333 DOI: 10.1186/s12889-021-12417-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sleep disordered breathing (SDB) plays a significant role in both sleep quality and cognition and whether it has an impact on the relationship between above two factors remains to be clear. The study aimed to explore the association between sleep quality and cognitive performance in general population by considering influence of sleep disordered breathing (SDB). METHODS In this cross-sectional study, we enrolled subjects aged ≥ 18 years using a multi-stage random sampling method. Cognitive status was assessed using Mini Mental State Examination (MMSE) questionnaire, sleep quality using Pittsburgh Sleep Quality Index (PSQI) and SDB was assessed using No-SAS scale, respectively. Multi-variable logistic regression was applied to examine the association of sleep quality and cognitive performance. Subgroup analyses were performed in different age groups, and in those with and without SDB. RESULTS Finally, 30,872 participants aged 47.5 ± 13.8 years with 53.5% women were enrolled, of whom 32.4% had poor sleep quality and 18.6% had low cognitive performance. Compared with good sleepers, subjects with poor sleep quality exhibited significantly higher presence of low cognitive performance (23.7% vs 16.2%, P < 0.001). Poor sleepers revealed 1.26 (95%CI: 1.16,1.36), 1.26 (1.08,1.46) and 1.25 (1.14,1.37) fold odds for low cognitive performance in general population and in subjects with and without self-reported SDB respectively. Stratified by age and SDB, the association was observed in young and middle-aged group without SDB (OR = 1.44, 95%CI: 1.30,1.59) and in the elderly group with SDB (OR = 1.30, 95%CI: 1.07,1.58). CONCLUSIONS Sleep quality is in a negative association with cognitive performance in general population independent of SDB, implying improvement of sleep disturbances is a potential objective of intervention strategies for cognitive protection at population level.
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Affiliation(s)
- Zhongrong Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Mulalibieke Heizhati
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Lin Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Mei Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Zhikang Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Mengyue Lin
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Reyila Abudereyimu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Jing Hong
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Wenbo Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Ling Yao
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Shasha Liu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Junli Hu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Nanfang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China. .,Xinjiang Hypertension Institute, Xinjiang, China. .,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China. .,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China. .,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China.
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Association between Plasma Homocysteine Concentrations and the First Ischemic Stroke in Hypertensive Patients with Obstructive Sleep Apnea: A 7-Year Retrospective Cohort Study from China. DISEASE MARKERS 2021; 2021:9953858. [PMID: 34621408 PMCID: PMC8492296 DOI: 10.1155/2021/9953858] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/16/2021] [Accepted: 09/21/2021] [Indexed: 12/16/2022]
Abstract
Purpose This study was aimed at investigating the association between baseline plasma homocysteine (Hcy) concentrations and the risk of the first ischemic stroke (IS) and at investigating any possible influential modifying factors in hypertensive patients with obstructive sleep apnea (OSA). Methods Cox proportional hazards regression was employed to investigate the relationship between plasma Hcy concentration and the first IS. A generalized additive model was applied to determine the nonlinear relationship. In addition, we conducted subgroup analysis. Results A total of 2350 hypertensive patients with OSA without a history of IS were enrolled in this study. At a median follow-up of 7.15 years, we identified 93 cases of the first IS. After adjusting for potential confounding, the findings revealed that plasma Hcy concentration was strongly and positively associated with the occurrence of the first IS (per SD increment; HR = 1.37, 95% CI: 1.30-1.44). A nonlinear relationship was found between plasma Hcy concentration and the risk of developing the first IS with inflection points for plasma Hcy of 5 μmol/L. In stratified analysis, a greater positive correlation was found between baseline plasma Hcy concentrations and new-onset IS in patients with DBP ≥ 90 mmHg (per SD increment; HR = 1.48, 95% CI: 1.33-1.65 vs. <90 mmHg: HR = 1.20, 95% CI: 1.02-1.42; P‐interaction = 0.04) and BMI ≥ 24 and <28 kg/m2 (per SD increment; HR = 1.46, 95% CI: 1.26-1.70 vs. <24 kg/m2: HR = 1.13, 95% CI: 0.95-1.33 vs. ≥28 kg/m2: HR = 1.46, 95% CI: 1.25-1.70; P‐interaction = 0.03). Conclusion Elevated plasma Hcy concentrations are independently associated with the risk of the first IS in hypertensive patients with OSA. Plasma Hcy concentrations ≥ 5 μmol/L surely increased the risk of the first IS in hypertensive patients with OSA.
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Heizhati M, Li N, Wang L, Hong J, Li M, Yang W, Yao L, Lin M, Pan F, Yang Z, Wang Z, Abudereyimu R. Association of Hypertension with Mild Cognitive Impairment in Population from Less-Developed Areas of Multiethnic Northwest China. Neuroepidemiology 2021; 55:407-415. [PMID: 34515156 DOI: 10.1159/000517956] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/10/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Relationship between hypertension and mild cognitive impairment (MCI) remains undetermined in population from less-developed regions. We aimed to explore whether hypertension is associated with MCI in this specific population. METHODS In this cross-sectional study, we enrolled subjects aged ≥18 years using multistage random sampling from Emin, China, in 2019. Participants underwent questionnaires and data collection including mini-mental state examination (MMSE) and blood pressure measurement. RESULTS Finally, 31,329 subjects were included, with 11,270 hypertensives. Compared with normotensive subjects, hypertensives were characterized by significantly older age (55.19 ± 12.25 vs. 43.26 ± 12.71), more men (52.5% vs. 42.9%), low education attainment (≤primary education: 42.4% vs. 26.3%), more abdominal obesity (39.7% vs. 19.1%), poor sleep quality (39.1% vs. 28.7%), and chronic kidney disease (6.6% vs. 3.4%, p for all <0.001). Prevalence of MCI in hypertensives was significantly higher than that of normotensive subjects (24.3% vs. 15.6%, p < 0.001). Multivariate logistic regression analysis showed in a fully adjusted model that the odds for MCI were significantly increased in hypertensives than in normotensive population (OR = 1.19, 95% CI: 1.09, 1.30, p < 0.001) and independent of all the parameters studied including age, education level, and stroke. In the age-stratified regression model, presence of hypertension significantly increased the odds of MCI by 1.17-fold (95% CI: 1.03, 1.33, p = 0.020) and by 1.22-fold (95% CI: 1.04, 1.44, p = 0.016) in middle-aged and elderly population. Sensitivity analysis of excluding those with stroke history showed that hypertension was still a risk factor for MCI in total, middle-aged, and elderly population. CONCLUSION Hypertension is in independent negative association with MCI in middle-aged and elderly population from underdeveloped regions.
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Affiliation(s)
- Mulalibieke Heizhati
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Nanfang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Lin Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Jing Hong
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Mei Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Wenbo Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Ling Yao
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Mengyue Lin
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Fengyu Pan
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Zhikang Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Zhongrong Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Reyila Abudereyimu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
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Yang Z, Heizhati M, Wang L, Li M, Pan F, Wang Z, Abudureyimu R, Hong J, Yao L, Yang W, Liu S, Li N. Subjective Poor Sleep Quality is Associated with Higher Blood Pressure and Prevalent Hypertension in General Population Independent of Sleep Disordered Breathing. Nat Sci Sleep 2021; 13:1759-1770. [PMID: 34675724 PMCID: PMC8517633 DOI: 10.2147/nss.s329024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/04/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To explore the relationship of subjective sleep quality with blood pressure (BP) and hypertension by considering the influence of sleep disordered breathing (SDB) and age in the general population. METHODS We evaluated sleep quality using the Pittsburgh sleep quality index (PSQI) and SDB using NoSAS score and measured BP in randomly selected adults in China in 2019. Sleep quality is categorized into four groups as very good, fairly good, fairly bad and very bad. SDB is defined as NoSAS score ≥8. Hypertension is defined as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg, and/or use of antihypertensive medicine within previous 2 weeks. Multi-variable linear and logistic regression analyses were used to assess the association of global PSQI score and sleep quality with BP and prevalent hypertension. RESULTS In the 33,341 participants (53.4% women, median age: 48 years), prevalence of hypertension significantly increased from very good to very bad sleepers in total (34.3 vs 42.6 vs 50.3 vs 58.5%), SDB (61.2 vs 68.3 vs 73.3 vs 75.5%) and non-SDB participants (26.8 vs 33.1 vs 40.1 vs 50.9%). In multiple linear regression, PSQI global score showed significant positive association with BP levels in total, SDB and non-SDB participants, consistent in sensitivity analysis by excluding participants who were taking antihypertensives, and in participants aged <60 years in age-stratified analysis. In multivariable logistic regression, odds ratio for presence of hypertension significantly increased from very good to very bad sleepers in total (1 vs 1.08 vs 1.22 vs 1.48), SDB (1 vs 1.17 vs 1.35 vs 1.28) and non-SDB participants (1 vs 1.05 vs 1.14 vs 1.53), consistent in participants aged <60 years. CONCLUSION Poor subjective sleep quality is significantly associated with higher BP and prevalent hypertension, independent of SDB in the young- and middle-aged general population, indicating potential of improving sleep quality to lower BP and optimize hypertension management at population level.
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Affiliation(s)
- Zhikang Yang
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Mulalibieke Heizhati
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Lin Wang
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Mei Li
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Fengyu Pan
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Zhongrong Wang
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Reyila Abudureyimu
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Jing Hong
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Ling Yao
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Wenbo Yang
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Shasha Liu
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Nanfang Li
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
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