Background Whether the ratio of siesta duration in the total sleep duration was associated with the occurrence of hypertension or cardiovascular diseases (CVDs) was unclear. Hypothesis To explore the associations of siesta, and siesta ratio with hypertension or CVDs in middle‐aged and older adults. Methods This cohort study collected the data of 9247 middle‐aged and older adults. The associations of siesta, and siesta ratio with hypertension were analyzed in 7619 participants while the associations of siesta, and siesta ratio with CVDs were analyzed in 8685 participants via univariate and multivariate logistic regression analysis. Results Total sleep duration < 6 h (odd ratio [OR] = 1.168, 95% confidence interval [CI]: 1.023−1.335) and siesta ratios ≥ 0.4 (OR = 1.712, 95% CI: 1.129–2.594) were associated with increased risk of hypertension in middle‐aged and older adults. Siesta ratio ≥ 0.4 was linked with higher risk of hypertension in males aged ≥ 60 years and total sleep duration < 6 h was correlated with elevated risk of hypertension in males < 60 years. The risk of CVDs was elevated in people with siesta duration < 0.5 h (OR = 2.053, 95% CI: 1.323−3.185). In females ≥60 years, the sleep duration at night < 6 h was associated with increased risk of CVDs. In females < 60 years, increased risk was observed in those with siesta duration < 0.5 h and sleep duration at night < 6 h. Conclusion Short sleep duration or high siesta ratio were associated with higher risk of hypertension. Short siesta duration, sleep duration at night or total sleep duration were correlated with an elevated risk of CVDs.
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