Abstract 14153: Actigraphy-Derived Rest-Activity Patterns Are Associated With Blood Pressure Level and Hypertension: A Prospective Analysis of the Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract

Introduction: Misalignment of lifestyle behaviors with circadian rhythms is related to hypertension (HTN) risk in experimental studies. Estimation of the circadian rhythm of 24 h rest-activity patterns, which serves as a measure of circadian rhythmicity in a free-living population setting, has been linked to health outcomes but its association with HTN is unknown. Hypothesis: Less robust and irregular 24 h rest-activity patterns will be associated with higher blood pressure (BP) and HTN. Methods: Participants were n=1667 diverse adults (mean age: 67 ± 9 y) in the MESA Sleep Study (2010-13) who completed 7 days of wrist actigraphy. Interdaily stability (IS), intradaily variability (IV), most active 10 h period (M10) and least active 5 h period (L5) timing and counts, and relative amplitude (RA) (defined in Table) were derived from actigraphy data using nonparametric rhythm analysis. Multivariable linear and logistic regression was used to examine associations with BP level and prevalent and incident HTN after 6 y of follow-up at Exam 6 (2016-18). Results: Greater RA (more robust rest-activity pattern i.e. higher wake-time activity and lower activity at night), IS (more day-to-day stability in rest-activity patterns), and M10 counts (more active wake period) were associated with lower BP (Table). Higher L5 midpoint and count (later timing and less restful sleep) was associated with higher BP. In sensitivity analyses excluding those taking HTN medication, associations persisted. Those in the highest vs. lowest category of RA and M10 counts had lower prevalent and incident HTN risk, while those in the highest vs. lowest category of L5 midpoint and counts and IV (more fragmented rhythm, lower sleep efficiency) had higher HTN risk. Conclusions: A less robust and stable rest-activity pattern, lower wake-time activity, and a less restful and later sleep period are associated with HTN. The timing and regularity of rest-activity patterns may be a novel target for HTN prevention.