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Gender-specific associations of short sleep duration with prevalent and incident hypertension : the Whitehall II Study

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Cappuccio, Francesco P., Stranges, Saverio, Kandala, Ngianga-Bakwin, Miller, Michelle A., Dr., Taggart, Frances M., Kumari, Meena, Ferrie, Jane E., Shipley, Martin J., Brunner, Eric and Marmot, Michael G.. (2007) Gender-specific associations of short sleep duration with prevalent and incident hypertension : the Whitehall II Study. Hypertension, Vol.50 (No.4). pp. 693-700. ISSN 0194-911X

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Abstract

Sleep deprivation (5 hour per night) was associated with a higher risk of hypertension in middle-aged
American adults but not among older individuals. However, the outcome was based on self-reported diagnosis of
incident hypertension, and no gender-specific analyses were included. We examined cross-sectional and prospective
associations of sleep duration with prevalent and incident hypertension in a cohort of 10 308 British civil servants aged
35 to 55 years at baseline (phase 1: 1985–1988). Data were gathered from phase 5 (1997–1999) and phase 7
(2003–2004). Sleep duration and other covariates were assessed at phase 5. At both examinations, hypertension was
defined as blood pressure 140/90 mm Hg or regular use of antihypertensive medications. In cross-sectional analyses
at phase 5 (n5766), short duration of sleep (5 hour per night) was associated with higher risk of hypertension
compared with the group sleeping 7 hours, among women (odds ratio: 2.01; 95% CI: 1.13 to 3.58), independent of
confounders, with an inverse linear trend across decreasing hours of sleep (P0.003). No association was detected in
men. In prospective analyses (mean follow-up: 5 years), the cumulative incidence of hypertension was 20.0% (n740)
among 3691 normotensive individuals at phase 5. In women, short duration of sleep was associated with a higher risk
of hypertension in a reduced model (age and employment) (6 hours per night: odds ratio: 1.56 [95% CI: 1.07 to 2.27];
5 hour per night: odds ratio: 1.94 [95% CI: 1.08 to 3.50] versus 7 hours). The associations were attenuated after
accounting for cardiovascular risk factors and psychiatric comorbidities (odds ratio: 1.42 [95% CI: 0.94 to 2.16]; odds
ratio: 1.31 [95% CI: 0.65 to 2.63], respectively). Sleep deprivation may produce detrimental cardiovascular effects
among women. (Hypertension. 2007;50:694-701.)
Key Words: sleep duration blood pressure hypertension gender differences confounders comorbidities

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Medicine > Warwick Medical School > Warwick Evidence
Faculty of Medicine > Warwick Medical School > Clinical Sciences Research Institute (CSRI)
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Sleep deprivation, Blood pressure, Hypertension, Sex differences
Journal or Publication Title: Hypertension
Publisher: American Heart Association
ISSN: 0194-911X
Official Date: 4 September 2007
Volume: Vol.50
Number: No.4
Page Range: pp. 693-700
Identification Number: 10.1161/HYPERTENSIONAHA.107.095471
Status: Peer Reviewed
Access rights to Published version: Open Access
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URI: http://wrap.warwick.ac.uk/id/eprint/176

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