The effect of sleep duration and sleep quality on hypertension in middle-aged and older Chinese: the Dongfeng-Tongji Cohort Study

Objective: To examine the independent and combined associations of sleep duration and sleep quality with hypertension in a middle-aged and older Chinese population. Methods: We included 21,912 individuals aged 62.2 years at baseline from September 2008 to June 2010, and they were followed until October 2013. Sleep duration was self-reported and sleep quality was evaluated with questions designed according to the Pittsburgh Sleep Quality Index. Hypertension was defined as blood pressure >= 140/90 mmHg, or self-reported physician diagnosis of hypertension, or self-reported current use of antihypertensive medication. Results: In the cross-sectional analyses, the odds ratio of hypertension prevalence was significantly elevated (OR = 1.13, 95% CI = 1.03-1.24) in those who slept less than 7 h after adjusting for sex, age, body mass index, midday napping, cigarette smoking and sleep quality. It was particularly evident among males (OR = 1.19, 95% CI = 1.01-1.40) and individuals who were thin (OR = 2.00, 95% CI = 1.01-3.93) with full adjustment. The association was also found for sleep duration of 9 similar to<10 h after adjusting various covariates (OR = 1.14, 95% CI = 1.04-1.27). In addition, impaired sleep quality was only associated with hypertension in obese individuals (OR = 1.25, 95% CI = 1.02-1.50), not in other subgroups. However, no significant association was detected in any category of sleep duration or sleep quality in all models in the prospective analyses, and the results remained unchanged in the subgroup analyses of sex, age and body mass index. Conclusions: The results of this study provide limited support for association of sleep duration and sleep quality with hypertension in middle-aged and older Chinese. Further studies are needed to confirm the results. (C) 2017 Elsevier B.V. All rights reserved.