P4403Sleep quality is associated with visit-to-visit blood pressure variability in elderly people

Abstract

Abstract Background The proportion of people suffering from poor sleep quality increases with age. Several studies reported that poor sleep quality is involved in elevation of blood pressure (BP) level and the development of hypertension. However, it is unclear whether sleep quality is associated with visit-to-visit BP variability, which is related to the incident cardiovascular disease independent of mean BP. Purpose In this study, we investigated the association between sleep quality and visit-to-visit BP variability in elderly people. Methods This is an observational study involving 3313 participants without atrial fibrillation, aged 68 years or older, who underwent assessment of sleep quality at general health examination between October 2014 and September 2015, and had more than four visits during the first 3 years following the assessment. Of these, 1951 participants (59%) had hypertension, 488 (17%) had diabetes, 432 (13%) had dyslipidemia, and 333 (10%) were on treatment for, or with a history of, cardiac disease. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), which yields seven component scores (0, 1, 2, or 3 is given for each component). A sum of the seven scores was used to calculate the global PSQI score which ranged from 0 to 21. Higher scores indicated poorer sleep quality. Visit-to-visit BP variability for each individual was evaluated by coefficient of variation (CV, defined as standard deviation/mean). Results The mean global PSQI score was 5.2±3.2. The mean CV of SBP and CV of DBP was 6.9±3.0, and 8.0±3.5, respectively. The global PSQI score was significantly associated with CV of SBP (ρ= 0.039, P=0.025), and CV of DBP (ρ= 0.039, P=0.024) in Spearman's rank correlation coefficient test. Multiple regression analyses showed that the global PSQI score was a significant contributor to CV of SBP, and CV of DBP, after adjusting for variables with P values <0.1 in Spearman's test (Table). Table 1. Multiple regression analysis for blood pressure variability (n=3313) Variables CV of SBP CV of DBP β P β P Age 0.131 <0.001 0.140 <0.001 Female −0.017 0.338 0.023 0.186 Hypertension 0.037 0.032 0.031 0.073 Cardiac disease 0.045 0.009 0.038 0.030 Global PSQI score 0.035 0.042 0.047 0.007 Conclusion Sleep quality is associated with visit-to-visit BP variability in elderly people.