Effects of sleep situation on circadian rhythm of blood pressure in elderly patients with hypertension / 中华老年医学杂志

ABSTRACT

Objective To explore the effects of sleep situation on circadian rhythm of blood pressure in elderly hypertension patients.Methods Two hundred and thirty patients (aged ≥ 60 years) with hypertension treated in the Department of Geriatric Cardiology of PLA General Hospital were enrolled in the study from October 2016 to December 2016.After admission,the clinical and laboratory tests data and examinations of the patients were collected and analyzed.The patients' sleep was investigated by Pittsburgh sleep quality index (PSQI).The ambulatory blood pressure rhythm was divided into three groupsreverse-dipper group (n=110),non-dipper group (n=86),and dipper group (n=34).The clinical data and sleep situation of different blood pressure rhythm groups were compared,and the effects of sleep situation on different blood pressure rhythm were analyzed.Results The total PSQI score with six domains[P＜0.01,except hypnotic drug (P＞0.05)]was significantly lower in dipper group than in reverse-and non-dipper group.The sleep situation was significantly better in dipper group than in reverse-and non-dipper group (P＜0.05).Multiple linear regression analysis showed a significant negative correlation between total PSQI score and nocturnal blood pressure drop after adjusting for risk factors of hypertension (β =-0.651,P ＜0.01).Furthermore,after further adjusting for the seven domains of the PSQI score,the negative correlation remained between the sleep time score and the nocturnal blood pressure drop (β=-1.926,P =0.031).The elderly hypertension patients with shorter sleep duration had a lower rate of nocturnal blood pressure decline,and were prone to present the reverse-dipper and non-dipper blood pressure rhythm.Conclusions The elderly hypertension patients with poor sleep quality,especially with short sleep duration,are prone to present the reverse-dipper and non-dipper blood pressure rhythm.Short sleep duration can be used as a predictor for abnormal blood pressure rhythm.