Abstract
BackgroundHypertension and dyssomnia are increasing significantly in Mongolians, and the related factors of ethnic differences in hypertension and dyssomnia between Mongolians and Han Chinese are unclear. This study examined the relationship of morning surge in blood pressure (MBP) with ethnicity, sleep situation, and sympathetic activity throughout the day.MethodsOf 692 hypertensive patients screened, 202 subjects with dyssomnia were selected. They were then divided into Mongolian (n = 87) and Han (n = 115) groups. The differences in dyssomnia, 24-h blood pressure, and urinary catecholamine were analyzed in all subjects; they were then further divided according to the degree of dyssomnia (low, moderate, and severe) to determine the differences in blood pressure and catecholamine.ResultsMongolians had a lower history of smoking, daytime dysfunction, nocturnal heart rates, and dopamine levels, but their body mass index, triglyceride, fasting glucose, morning surge in systolic blood pressure (MSBP), nocturnal systolic blood pressure (NSBP), nocturnal diastolic blood pressure, daytime systolic blood pressure, daytime heart rates, and dopamine level (D-DA) were higher than those of Han Chinese. With the aggravation of dyssomnia, MSBP, NSBP, D-NE, daytime epinephrine, and D-DA of Mongolians and Han Chinese increased gradually, but the rate of increase was faster in the latter (p < 0.05). D-DA was entered into the MSBP regression model of Mongolians (intercept, 157 mmHg), whereas D-DA and D-NE were entered into the MSBP regression model of Han Chinese (intercept, 142 mmHg).ConclusionWorsened dyssomnia induces higher MSBP and augments sympathetic excitability in Mongolians and Han Chinese. Mongolians with hypertension and dyssomnia had higher MSBP baseline and D-DA but lower N-DA. With an increase in D-DA, MSBP in Han and Mongolian patients increased gradually.
Highlights
Evidence from previous studies suggests that dyssomnia can increase the incidence of high blood pressure, even if it is a single factor that can lead to high blood pressure in a given environment for quite a time (Joyner, Charkoudian & Wallin, 2010)
Some studies have shown that elevated morning surge in blood pressure (MBP) is related to sympathetic overactivity and the destruction of the body’s normal blood pressure rhythm, and it is associated with alterations in sympathetic excitability during sleep (Johnson et al, 2016; Okada et al, 2013)
Because of incomplete registration of subjects, liver and kidney dysfunctions, nonstandardized ambulatory blood pressure monitoring (ABPM) data, and failed urine catecholamine specimens, 69 patients were excluded, and 202 complete data of hypertensive patients with dyssomnia were included in the study (Han, n = 115, 56.93%; Mongolians, n = 87, 43.07%) (Fig. 1)
Summary
Evidence from previous studies suggests that dyssomnia can increase the incidence of high blood pressure, even if it is a single factor that can lead to high blood pressure in a given environment for quite a time (Joyner, Charkoudian & Wallin, 2010). Some studies have shown that elevated MBP is related to sympathetic overactivity and the destruction of the body’s normal blood pressure rhythm, and it is associated with alterations in sympathetic excitability during sleep (Johnson et al, 2016; Okada et al, 2013). Hypertension and dyssomnia in Mongolians are increasing significantly (Li et al, 2016a), and the related factors of ethnic differences in hypertension and dyssomnia between these two populations are unclear. We conducted a prospective cross-sectional study to confirm the hypothesis that Mongolian patients with hypertension and dyssomnia have more obvious increase in sympathetic excitability, higher MBP, and closer correlation between sympathetic activity and MBP, compared with Han patients
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