Abstract P279: Marijuana Use, Multiple Sleep Characteristics, and Hypertension Among White, Black, and Hispanic Adults in the United States

Abstract

Introduction: Prior studies have found an association between marijuana use and hypertension. However, few consider the role of sleep as an explanatory factor or race/ethnicity as a moderator. Our objective was to investigate associations between marijuana use, sleep characteristics, and hypertension in a multiethnic population. Hypothesis: We hypothesized that the marijuana use and sleep association would vary by race/ethnicity and sleep would partially explain associations between marijuana use and hypertension. Methods: We used National Comorbidity Survey-Replication cross-sectional data (2001-2003) from white, black, and Hispanic participants aged ≥18 years who reported no current abuse of cocaine or prescription drugs. Participants self-reported marijuana use, multiple sleep characteristics (insomnia symptoms, early awakening, daytime sleepiness), and a physician’s diagnosis of hypertension (yes vs. no). Using Poisson regression with robust variance and sampling weights, we estimated the prevalence of poor sleep characteristics among participants who reported current or former use to never use adjusting for age, sex, and race/ethnicity. Sleep characteristics were added to adjusted models for associations between use and hypertension. Race/ethnicity*marijuana use interaction terms were tested for all models. Results: Among 3,928 participants, mean age±SE was 45±0.49 years, 79% were white, 11% black, and 10% Hispanic. Current users were younger (32±0.49 years), more likely to report black (17%) or Hispanic (13%) race/ethnicity and insomnia symptoms (31%), and less likely to report hypertension (12%) compared to former (40.6±0.45 years, 9.6% black, 9.9% Hispanic, 26% insomnia, 20% hypertension) and never (51.1±0.79 years, 10% black, 9.9% Hispanic, 22% insomnia, 29% hypertension) users. Estimates were similar across marijuana use categories for early awakening (16%) and daytime sleepiness (34%). Former and current marijuana use was associated with 22% (whites) to 38% (blacks) and 33% (Hispanics) to 85% (blacks, prevalence ratio (PR)=1.85 [95% confidence interval: 1.06-3.23]) higher prevalence of insomnia symptoms as well as 32% (blacks) to 49% (whites) and 46% (blacks) to 77% (whites, PR=1.77 [1.29-2.44]) higher prevalence of early awakening (p race/ethnicity*marijuana use <0.05). Across all races/ethnicities, marijuana use was similarly associated with higher prevalence of daytime sleepiness (PR former =1.17 [1.03-1.33], PR current =1.20 [1.00-1.43]). Former marijuana use was associated with higher prevalence of hypertension only among blacks (PR=1.46 [1.04-2.05]) and sleep characteristics explained approximately 2% of this association on average. Conclusions: Marijuana use was associated with poor sleep and relationships varied by race/ethnicity, but relationships between marijuana use and hypertension were not explained by sleep.