Ethnic Differences in Sleep Quality Accompany Ethnic Differences in Night-time Blood Pressure Dipping

Hughes, Joel W.; Kobayashi, Ihori; Deichert, Nathan T.

doi:10.1016/j.amjhyper.2007.05.005

Cited by 35 publications

(50 citation statements)

References 22 publications

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“…The literature is divided on whether nocturnal SAP dipping is associated with sleep efficiency in hypertension (21,28,41). However, the few studies that assessed sleep by actigraphy with ABPM in normotensive and prehypertensive adolescents and young adults did not find an association between sleep efficiency and SAP dipping (22,32). There are several possibilities that may explain our conflicting results.…”

Section: Discussioncontrasting

confidence: 47%

“…In our study design, sleep data were acquired for several nights across the span of 1 mo, and ABPM was obtained on a nonactigraphy night to account for the reported impact of ABPM on sleep (13,22,33). When controlling for these potential confounds, we observed that low sleep efficiency was significantly associated with blunted SAP and heart rate dipping at night in normotensive young adults.…”

Section: Discussionmentioning

confidence: 99%

“…These discrepancies remain unresolved, but methodological limitations must be considered. Of specific interest to the present study, these prior studies (2, 21, 22, 27, 28, 30 -32, 41, 43) have recorded sleep efficiency and nocturnal ambulatory blood pressure concurrently, despite evidence that nocturnal ambulatory blood pressure monitoring (ABPM) can artificially reduce sleep efficiency (13,22,33). Moreover, previous studies have categorized subjects according to blood pressure dipping status instead of sleep efficiency.…”

mentioning

confidence: 97%

“…Sleep efficiency can be objectively quantified using noninvasive limb actigraphy (1,5,11,26,29,34,40,42). A number of studies have examined the associations between sleep efficiency and 24-h ambulatory blood pressure in both adults (21,22,27,28,31,41,43) and adolescents (2,30,32). While some studies report a significant correlation between reduced sleep efficiency and a blunted nocturnal systolic arterial pressure (SAP) dip (2,28,31,41), others report no association (22,27,30,32,43).…”

mentioning

confidence: 99%

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Sleep efficiency and nocturnal hemodynamic dipping in young, normotensive adults

Ross

Yang

Larson

et al. 2014

American Journal of Physiology-Regulatory, Integrative and Comp

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Blunted dipping of nocturnal systolic arterial pressure (SAP) and heart rate (HR) are independent risk factors for hypertension and all-cause mortality. While several epidemiological studies report a significant association between short sleep duration and hypertension, associations between sleep efficiency and the nocturnal drop of SAP remain controversial. Moreover, relations between sleep efficiency and HR diurnal patterns have been overlooked. We hypothesized that low sleep efficiency (<85%) would be associated with blunted nocturnal SAP and HR dipping. Twenty-two normotensive subjects (13 men, 9 women; age: 18–28 yr) wore an actigraphy watch for 7 days and nights, and an ambulatory blood pressure monitor for 24 h on a nonactigraph night. There were no differences in age, sex, body mass index, mean sleep time, number of awakenings, or 24-h blood pressure between the low ( n = 12) and high ( n = 10) sleep efficiency groups. However, the low sleep efficiency subjects demonstrated a blunted dip of nocturnal SAP (10 ± 1% vs. 14 ± 1%, P = 0.04) and HR (12 ± 3% vs. 21 ± 3%, P = 0.03) compared with the high sleep efficiency group. The low sleep efficiency group also demonstrated a higher mean nocturnal HR (63 ± 2 vs. 55 ± 2 beats/min; P = 0.02). These findings support growing evidence that sleep efficiency, independent of total sleep time, may be an important cardiovascular risk factor.

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Section: Discussioncontrasting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 97%

mentioning

confidence: 99%

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Sleep efficiency and nocturnal hemodynamic dipping in young, normotensive adults

Ross

Yang

Larson

et al. 2014

American Journal of Physiology-Regulatory, Integrative and Comp

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“…In addition, the prevalence of resistant hypertension is greater in patients with African ancestry than whites [3]. Furthermore, black patients have smaller night dip in systolic blood pressure (SBP) [8]. As a result, an increased CVD prevalence and mortality associated with hypertension is observed in patients with African ancestry [9].…”

Section: Hypertension In Patients With African Ancestrymentioning

confidence: 91%

Antihypertensive drug therapy in patients with African ancestry

Rizos

Elisaf

2014

Expert Opinion on Pharmacotherapy

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The reproducibility of ethnic differences in the proportional awake–sleep blood pressure decline among women

Berge-Landry

Bovbjerg

James

2010

American J Hum Biol

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A growing body of evidence indicates that African Americans (AA), on average, have a smaller proportional decline in blood pressure (BP) from waking to sleep than European Americans (EA), but this difference is largely based on correlational data from a single assessment day. The persistence of this difference over repeated sampling is not well established. The purpose of this study was to evaluate whether ethnic differences in the awake-sleep BP decline between AA and EA persisted over three monthly assessments. The subjects were 47 AA (age = 39.7 +/- 8.7) and 92 EA (age = 37.4 +/- 9.2) normotensive women. Subjects had 24-h ambulatory BP monitoring done on midweek workdays at 1-month intervals for three consecutive months. The proportional decline in BP was calculated as follows: (average awake - average sleep)/average sleep. The persistence of ethnic differences was evaluated using repeated-measures ANCOVA and by examining Bland-Altman plots. The ANCOVA results revealed that overall, the proportional decline of AA women was less than that of EA women for both SBP (P < 0.038) and DBP (P < 0.083), consistent with previous research, and that there were also no significant ethnic differences by monthly assessment. Bland-Altman plots revealed that overall and by ethnicity, the proportional decline in BP among individual subjects over the 3 months was also reproducible. These results suggest that the ethnic difference in awake-sleep BP between AA and EA women persists over time and that the awake-sleep decline in BP among individuals, whether AA or EA, is also reproducible.

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Ethnic Differences in Sleep Quality Accompany Ethnic Differences in Night-time Blood Pressure Dipping

Abstract: Sleep quality accompanied ethnic differences in systolic and diastolic BP dipping, but did not account for these differences.

Cited by 35 publications

References 22 publications

Sleep efficiency and nocturnal hemodynamic dipping in young, normotensive adults

Sleep efficiency and nocturnal hemodynamic dipping in young, normotensive adults

Antihypertensive drug therapy in patients with African ancestry

The reproducibility of ethnic differences in the proportional awake–sleep blood pressure decline among women

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