Abstract P406: Sleep Health as an Important Determinant of Elevated Blood Pressure: A Population Based Study

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Introduction: One mechanism elucidating the association between lack of sleep and elevated blood pressure includes over-activity of the sympathetic neurotransmitters which in turn raises the levels of adrenaline in the blood. Persistently raised adrenaline levels directly elevate heart rate, systolic blood pressure (SBP) and the diastolic blood pressure (DBP). We aimed at evaluating the association of sleep duration with blood pressure among the adult population in the United States after adjusting for the confounding effects of age, gender, BMI, income poverty ratio (IPR), and race. Methods: Our study was based on a population-based cross-sectional study design, comprising of a nationally representative sample of US adults derived from the National Health and Nutrition Examination Survey (NHANES) data cycle 2013-2014 (N=6266). Study population comprised of adults aged 16 years or above who had participated in both interview and medical examination components of the NHANES survey. Measurements on SBP, DBP, and BMI were obtained at the designated clinic by trained personnel, while age, gender, IPR, and race were recorded during the interview by self-report. Results: Of 6266 participants, aged between 16 to 80 years with a mean age of 45( + 9.2) years, a total of 2302 (34%) reported short sleep duration (<6 hours per day) (Table 1). The outcome variables, SBP and DBP, were significantly different across short and normal sleep duration (p-value <0.05) (Table 1). SBP and DBP were also significantly different among males and females (p-value <0.0001) (Table 2). Both unadjusted and adjusted analyses showed a statistically significant association between sleep duration and DBP [b adjusted = -0.42, sd=0.16, 95%CI= -0.74, 0.08, p-value= 0.02]. When stratified by gender, the association was only significant for males [b adjusted = -0.50, sd=0.20, 95%CI= -0.90, -0.09, p-value = 0.02] (Table 3). Conclusion: Sleep health is a significant determinant of elevated blood pressure in our data even when BMI was held constant. Prospective studies are needed to augment the understanding of this association to seek early public health and behavioral interventions for the prevention of premature cardiovascular morbidity.