Abstract 073: Sleep Duration and 24-hour Ambulatory Blood Pressure in Adults not on Antihypertensive Medications

Abstract

Background: Short sleep duration has been widely linked to increased cardiovascular morbidity and mortality, although the underlying mechanisms for this relationship remain unclear. Maladaptive circadian variations in blood pressure (BP) may be an important mediator of adverse outcomes in people with short sleep duration. Our goal was to evaluate the association between sleep duration and 24-hour BP control. Methods: We performed a post-hoc analyses of 24-hour ambulatory BP monitoring in 219 non-hypertensive and pre-hypertensive adults in the Lifestyle Modification in BP Lowering Study (LIMBS) and Penn Icelandic Sleep Apnea (PISA) Study. Results: The 24-hour mean systolic BP was 12.7 mmHg higher in LIMBS (see Figure; p<0.001) and 4.7 mmHg higher in PISA (p=0.005) among participants with shorter sleep duration (<7 hours) compared to those with longer sleep duration (≥7 hours). There was a 1 mmHg higher 24-hour mean systolic BP for every 2.57 minute shorter sleep duration in LIMBS (95% CI -4.56 to -0.58; p<0.001), and a 1 mmHg higher 24-hour mean systolic BP for every 1.99 minute shorter sleep duration in PISA (95% CI -3.48 to -0.50; p=0.009). There was no significant association between sleep duration and BP variability, nocturnal dipping, or in-office systolic BP. Conclusions: Shorter sleep duration is strongly associated with higher systolic BP on 24-hour ambulatory BP monitoring; the association seems to be independent of nocturnal and in-office BP. Adults with shorter sleep duration may benefit from screening with 24-hour ambulatory BP monitoring to promote earlier detection of hypertension and potentially mitigate their increased risk for future cardiovascular disease.