Increased Risk Of Hypertension Research Articles

Hypertension in military veterans is associated with combat exposure and combat injury

Although the long-term effects of combat injury are not well understood, there is emerging concern that exposure to combat environments and subsequent injury may increase the risk of hypertension through changes in inflammatory responses, psychological stress and mental health, and health behaviors. Data from the Millennium Cohort Study and the Department of Defense Trauma Registry were used to identify combat-exposed and combat-injured participants. Incident hypertension diagnoses were ascertained from the Millennium Cohort survey. The associations between combat exposure/injury and hypertension risk was estimated using multivariable complementary log-log survival models. The final analysis sample consisted of 38 734 participants. Of these, 50.8% deployed but were not exposed to combat, 48.6% deployed and were exposed to combat, and 0.6% had combat injury. Overall prevalence of hypertension was 7.6%. Compared with participants who deployed but did not experience combat (mild exposure), elevated odds of hypertension were observed among those who experienced combat but not wounded (moderate exposure; AOR, 1.28; 95% CI, 1.19-1.38) and those wounded in combat (high exposure; AOR, 1.46; 95% CI, 1.07-2.00). Sleep duration of less than 4 h (AOR, 1.21; 95% CI, 1.03-1.43), sleep duration of 4-6 h (AOR, 1.16; 95% CI, 1.05-1.29), posttraumatic stress disorder (AOR, 1.54; 95% CI, 1.26-1.87), and overweight (AOR, 1.77; 95% CI, 1.61-1.95) and obese (AOR, 2.77; 95% CI, 2.45-3.12) status were also associated with higher odds of hypertension. Results support the hypotheses that combat exposure increases hypertension risk and that combat injury exacerbates this risk.

Lifecourse Drinking Patterns, Hypertension, and Heart Problems Among U.S. Adults

Understanding the role of alcohol in hypertension and heart problems requires a lifecourse perspective accounting for drinking patterns before onset of health problems that distinguishes between lifetime abstinence and former drinking, prior versus current drinking, and overall alcohol consumption in conjunction with heavy episodic drinking. Using prospective data among U.S. adults aged 21-55 years, this study accounts for these lifecourse factors to investigate the effect of alcohol on hypertension and heart problems. Data from the U.S. National Longitudinal Survey of Youth, aged 14-21 years in 1979 and followed through 2012 (n=8,289), were analyzed in 2017-18 to estimate hypertension and heart problems onset from lifecourse drinking patterns. Discrete-time survival models stratified by sex and race/ethnicity, controlling for demographics and time-varying factors of employment, smoking, and obesity. Elevated risks for hypertension were found for women drinking >14 drinks/week regardless of any heavy drinking (AOR=1.57, p=0.023) and for men engaged in risky drinking (15-28 drinks/week) together with monthly heavy drinking (AOR=1.64, p=0.016). Having a history of weekly heavy drinking elevated the risk for women but not for men. No significant relationship was evident for alcohol and heart problems onset. This study confirms previous findings of increased hypertension risk from higher volume and heavier drinking patterns among women and men but did not find any support for increased heart problems risk, which may be due to the younger age profile of the sample. Further research that incorporates lifecourse drinking patterns is needed to better understand the alcohol-health relationship.

The impact of glycated hemoglobin on risk of hypertension: a Mendelian randomization study using UK Biobank.

Observational studies suggest higher glycated hemoglobin (HbA1c) associated with higher hypertension risk although these associations could be confounded. We examined the relation using a Mendelian randomization design in a large Biobank, the UK Biobank. We identified 38 single nucleotide polymorphisms (SNPs) strongly and independently related to HbA1c from a large genome wide association study (n = 123 665) and applied them to the UK Biobank (n = 376 644). We used inverse variance weighting (IVW) to assess the relation of HbA1c with risk of hypertension (defined using the American College of Cardiology/American Heart Association 2017 guidelines), and SBP and DBP. Sensitivity analyses included Mendelian randomization-Egger, weighted median, Mendelian randomization pleiotropy residual sum and outlier and exclusion of pleiotropic SNPs. HbA1c was not clearly associated with hypertension risk using IVW (odds ratio 1.11, 95% confidence interval 0.76-1.62) in the main analysis. However, Mendelian randomization pleiotropy residual sum and outlier suggested potential horizontal pleiotropy. After excluding potentially invalid SNPs, HbA1c was associated with hypertension risk (IVW odds ratio 1.22 per %, 95% confidence interval 1.01-1.46), with consistent estimates from sensitivity analyses. HbA1c was positively associated with SBP in some, but not all analyses, albeit with directionally consistent estimates. The relation with DBP was unclear. Our study suggests HbA1c may increase hypertension risk and could be one underlying mechanistic pathway between HbA1c and coronary artery disease risk.

The Impact of CYP24A1 Polymorphisms on Hypertension Susceptibility

Background: Hypertension is one of the leading causes of human death and disability. CYP24A1 regulates vitamin D activity and is closely linked to hypertension. However, the relationship between CYP24A1polymorphisms and hypertension risk remains unclear. Methods: This case-control study included 503 hypertensive patients and 498 healthy controls from the Chinese Han population. The genotypes of CYP24A1polymorphisms were detected using the Agena MassARRAY method. The association between genetic variations of CYP24A1and hypertension risk was evaluated with odds ratios (OR) and 95% confidence intervals (CI) in genetic models. Results: We found that rs56229249 of CYP24A1significantlydecreased the hypertension risk in homozygote (OR 0.51, 95% CI 0.29–0.91, p = 0.022) and recessive models (OR 0.51, 95% CI 0.29–0.91, p = 0.023). Further stratification analyses indicated that hypertension risk is related to age and sex, rs2762934 polymorphism increases hypertension risk among younger subjects (<61 years), and rs1977297 influences the risk of hypertension among older subjects (≥61 years). In addition, rs2762940 is related to hypertension risk in men, and rs56229249 is a protective factor against hypertension in women. Conclusions: Our study suggests that genetic variations of the CYP24A1gene were significantly associated with susceptibility to hypertension in the Chinese population.

You are What You Think Your Social Network Eats: Public Housing, Social Networks, and Fast-Food Consumption.

High-sodium diets (e.g., fast-food intake, FF) may contribute to increased hyper-tension risk among low-income populations. We examined the association between FF intake and perceived social-network member FF intake among Baltimore public housing residents. We analyzed 2014-2015 cross-sectional data. Our dependent variable was FF intake (eating FF weekly versus not), and our independent variable was perceiving one or more network member eating FF weekly. We used multivariable Poisson regression with robust variance, adjusted for individual and network covariates. The 266 public housing residents had mean age 44.5 years: 86.1% women, 95.5% African American, 56.8% hypertension, and 42.8% who ate FF weekly. Residents were significantly more likely to eat FF weekly if they perceived that their network contained one or more members who consumed FF weekly (relative risk 1.50, 95%CI 1.05-2.14, p=.02). Given the association between personal and social network consumption of FF weekly, further investigation may be warranted of novel social network interventions for dietary behavior change.

Objective short sleep duration increase risk of hypertension in young adults with sleep apnea

Objective short sleep duration increase risk of hypertension in young adults with sleep apnea

Association of bisphenol A and its alternatives bisphenol S and F exposure with hypertension and blood pressure: A cross-sectional study in China

Epidemiological studies have investigated the associations of bisphenol A (BPA) exposure with hypertension risk or blood pressure levels, but findings are inconsistent. Furthermore, the association between its alternatives bisphenol S and F (BPS and BPF) and hypertension risk are not yet known. We conducted a cross-sectional study in 1437 eligible participants without hypertension-related diseases, with complete data about blood pressure levels, hypertension diagnosis, and urinary bisphenols concentrations. Multivariable logistic and linear models were respectively applied to examine the associations of urinary bisphenols concentrations with hypertension risk and blood pressure levels. The dose-response relationship was explored by the restricted cubic spline model. Compared with the reference group of BPA, individuals in the middle and high exposure group had an adjusted odds ratio (OR) of 1.30 and 1.40 for hypertension, had a 3.08 and 2.82 mm Hg higher systolic blood pressure (SBP) levels, respectively, with an inverted “U” shaped dose-response relationship. Compared with the reference group of BPS, individuals in the second and third tertile had an adjusted OR of 1.49 and 1.48 for hypertension, had a 2.61 and 3.89 mm Hg increased levels of SBP, respectively, with a monotonic curve. No significant associations of BPF exposure with hypertension risk or blood pressure levels were found. BPA and BPS exposure were suggested to be associated with increased hypertension risk and blood pressure levels, with different dose-response relationships. Our findings have important implications for public health but require confirmation in prospective studies.

Soluble guanylate cyclase contribute genetic susceptibility to essential hypertension in the Han Chinese population.

Animal study found that soluble guanylate cyclase (sGC) plays an important role in development of hypertension (HT) by affecting the NO-sGC-CGMP signaling pathway. This study aims to evaluate the association of sGC with essential hypertension (EH) in the Han Chinese population. This case-control study included 2,012 hypertensive cases and 2,210 controls, and 6 tagging single nucleotide polymorphisms (SNPs) were selected (rs3806777, rs3806782, rs3796576 and rs7698460 in GUCY1A3, as well as rs2229202 and rs1459853 in GUCY1B3). Then the association of the six SNPs with EH was further evaluated in this study. The results indicated that the A/A genotype of rs1459853 in GUCY1B3 was associated with higher HT risk, and the odds ratio (OR) of its recessive model was 1.191 (P=0.044). After adjusting for covariates, the association was still significant. Further stratification analyses showed that rs1459853 in non-drinking subjects and rs7698460 in women were associated with EH. In the follow-up study, rs1459853 were related to increased HT risk in men and smoker subjects. In adolescents, rs2229202 that in GUCY1B3 had significant association with prehypertension (Pre-HT), HT, and prehypertension with hypertension (Pre-HT + HT). After adjusted for covariates, the association was remaining significant. And in girls, rs3806782 was significantly connected with HT and Pre-HT + HT. Overall, our findings suggest that sGC may contribute to the genetic susceptibility to EH, and it was validated for the first time in adolescents.

Resting heart rate and its dynamic change and the risk of hypertension: The Rural Chinese Cohort Study.

The sex- and age-specific relation in the association of resting heart rate (RHR) and its change and risk of hypertension remains unclear. We prospectively estimated the incidence of hypertension among 9969 nonhypertensive adults participating in The Rural Chinese Cohort Study. Self-reported questionnaires and anthropometric and laboratory measurements were collected at baseline (2007-2008) and follow-up (2013-2014). The modified Poisson regression model was used to calculate relative risk (RR) values and 95% confidence intervals (CIs) for incident hypertension associated with RHR and its dynamic change. During follow-up (median, 6.01 years), 797 (20.28%) men, and 1178 (19.51%) women developed hypertension. Risk of hypertension was increased for women with the highest versus lowest RHR tertile after adjusting for confounding factors (RR: 1.19 [95%CI: 1.04-1.36]) and was associated with increased RHR for women with young age (RR per 10-beat/min RHR increase, 1.25 [95%CI: 1.09-1.43]), middle age (1.06 [0.99-1.14]), and older age (1.11 [1.01-1.23]). Risk of developing hypertension was significantly higher (RR: 1.22 [95%CI: 1.04-1.42]) in women with high RHR (≥80-beat/min) throughout the study period than those with normal RHR (<80-beat/min). No significant association of RHR and hypertension was found in men. RHR is an independent predictor of hypertension in rural Chinese women. Persistently high RHR is associated with increased hypertension risk in women. The dose-response association between RHR and hypertension could be affected by sex and age status.

Bilateral high-frequency hearing loss is associated with elevated blood pressure and increased hypertension risk in occupational noise exposed workers.

ObjectiveTo investigate the association of bilateral high-frequency hearing loss (BHFHL) with blood pressure and hypertension among occupational noise exposed workers.MethodsOccupational noise exposed workers were enrolled in 2017 from the occupational diseases survey of Chengdu. BHFHL was classified as normal, mild, or high by the bilateral high-frequency tone average. Linear regression model was used to assess the effects of occupational noise exposure time and BHFHL on blood pressure. Logistic regression model was performed to estimate hypertension risk odds ratios (ORs) associated to occupational noise exposure time and BHFHL.ResultsIncreasing years of occupational noise exposure and BHFHL were significantly associated with systolic and diastolic blood pressure increase (all P<0.001). The lineal trend was only significant in males, with adjusted ORs for hypertension gradually increasing with increasing years of occupational noise exposure (P<0.001). Furthermore, subjects having mild and high BHFHL had a higher hypertension risk of 34% and 281%, respectively (both P<0.001). Dose-response relationship between BHFHL and hypertension was found in both males and females.ConclusionsOccupational noise exposure was positively associated with blood pressure levels and hypertension risk.

Effects of SR-BI rs5888 and rs4238001 variations on hypertension

Abstract Background Scavenger receptor class B, type I (SR-BI), involved in reverse cholesterol pathway, is a multilipoprotein receptor and capable of binding HDL, LDL and VLDL. SR-BI may contribute to the development of hypertension due to accumulation of cholesterol in the vessel wall via transporting lipoproteins. Therefore, it was aimed to investigate the relationship between SR-BI rs5888 and rs4238001 variants in the patient with hypertension. Materials and methods Seventy three subjects diagnosed with hypertension and 76 healthy subjects constituted the patient and control group, respectively. Genomic DNA was isolated from peripheral blood samples and a real-time quantitative polymerase chain reaction protocol was performed to detect variations of rs5888 and rs4238001. The results were analyzed with the SPSS 22 program and p &lt; 0.05 was considered statistically significant. Results and discussion SR-BI rs4238001 variation did not show significant difference between patient and control group (p &gt; 0.05). In the SR-BI rs5888 variation; normal homozygous CC and heterozygous CT carriers had an average 2-fold lower risk of hypertension than those carrying the TT genotype (p &lt; 0.05). Conclusion SR-BI rs5888 TT variant may increase hypertension risk by reducing lipid transport to the liver from the vessel wall.

Working Together with God: Religious Coping, Perceived Discrimination, and Hypertension.

This study examined the relationships of perceived discrimination and religious coping with hypertension in a sample of Black and White Seventh-day Adventists. Data come from a community-based sample of 6128 White American, 2253 African American and 927 Caribbean American adults (67% women; mean age = 62.9years). Results indicate lifetime unfair treatment was significantly associated with hypertension regardless of race/ethnicity. Positive religious coping was associated with lower odds of hypertension and did not interact with unfair treatment. Both positive and negative religious coping were indirectly associated with increased hypertension risk through an increase in perceived discrimination.

Abstract 275: The Association of Gout with an Increased Risk of Hypertension and Diabetes Mellitus Among Stroke Survivors in New Zealand: An Observational Study Using Routinely-collected Electronic Health Data

Background: There is a paucity of data relating to the association of gout with the occurrence of hypertension and diabetes mellitus in patients with stroke. This study aimed to determine the association of gout with the risk of hypertension and diabetes mellitus in a cohort of stroke patients from Auckland, New Zealand. Methods: A cross-sectional study was conducted among stroke survivors in South and East Auckland, New Zealand from the years 2010 to 2014. Electronic health record data were collected and analysed using SPSS version 23. Multivariate logistic regression modelling adjusted for age, gender, and ethnicity was conducted to determine the association of gout with the risk of hypertension and diabetes mellitus in patients discharged with a diagnosis of stroke. Results: The age-, gender-, and ethnicity-adjusted odds ratio (OR) for having hypertension and diabetes mellitus among stroke survivors with gout history were: 3.25 [95% confidence interval (CI) 1.32-8.03] and 1.94 (95% CI 1.12-3.36), respectively. Måori stroke survivors with gout history had the highest risk of having diabetes mellitus with age- and gender-adjusted OR of 5.10 (95% CI 1.90-18.93). Conclusion: The findings from this study suggest gout may be independently associated with an increasedrisk of hypertension and diabetes mellitus in patients with stroke. Måori who are the indigenous population of New Zealand show a greater risk of diabetes mellitus associated with a gout history compared to other populations. This finding highlights the importance of the need for further research on the association of gout with hypertension and diabetes mellitus.

Not all posttraumatic stress disorder symptoms are equal: fear, dysphoria, and risk of developing hypertension in trauma-exposed women.

Posttraumatic stress disorder (PTSD) is associated with higher risk of incident hypertension, but it is unclear whether specific aspects of PTSD are particularly cardiotoxic. PTSD is a heterogeneous disorder, comprising dimensions of fear and dysphoria. Because elevated fear after trauma may promote autonomic nervous system dysregulation, we hypothesized fear would predict hypertension onset, and associations with hypertension would be stronger with fear than dysphoria. We examined fear and dysphoria symptom dimensions in relation to incident hypertension over 24 years in 2709 trauma-exposed women in the Nurses' Health Study II. Posttraumatic fear and dysphoria symptom scores were derived from a PTSD diagnostic interview. We used proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for each symptom dimension (quintiles) with new-onset hypertension events (N = 925), using separate models. We also considered lower-order symptom dimensions of fear and dysphoria. Higher levels of fear (P-trend = 0.02), but not dysphoria (P-trend = 0.22), symptoms were significantly associated with increased hypertension risk after adjusting for socio-demographics and family history of hypertension. Women in the highest v. lowest fear quintile had a 26% higher rate of developing hypertension [HR = 1.26 (95% CI 1.02-1.57)]; the increased incidence associated with greater fear was similar when further adjusted for biomedical and health behavior covariates (P-trend = 0.04) and dysphoria symptoms (P-trend = 0.04). Lower-order symptom dimension analyses provided preliminary evidence that the re-experiencing and avoidance components of fear were particularly associated with hypertension. Fear symptoms associated with PTSD may be a critical driver of elevated cardiovascular risk in trauma-exposed individuals.

HFE H63D Polymorphism and the Risk for Systemic Hypertension, Myocardial Remodeling, and Adverse Cardiovascular Events in the ARIC Study.

H63D has been identified as a novel locus associated with the development of hypertension. The quantitative risks for hypertension, cardiac remodeling, and adverse events are not well studied. We analyzed white participants from the ARIC study (Atherosclerosis Risk in Communities) with H63D genotyping (N=10 902). We related genotype status to prevalence of hypertension at each of 5 study visits and risk for adverse cardiovascular events. Among visit 5 participants (N=4507), we related genotype status to echocardiographic features. Frequencies of wild type (WT)/WT, H63D/WT, and H63D/H63D were 73%, 24.6%, and 2.4%. The average age at baseline was 54.9±5.7 years and 47% were men. Participants carrying the H63D variant had higher systolic blood pressure ( P=0.004), diastolic blood pressure (0.012), and more frequently had hypertension ( P<0.001). Compared with WT/WT, H63D/WT and H63D/H63D participants had a 2% to 4% and 4% to 7% absolute increase in hypertension risk at each visit, respectively. The population attributable risk of H63D for hypertension among individuals aged 45 to 64 was 3.2% (95% CI, 1.3-5.1%) and 1.3% (95% CI, 0.0-2.4%) among individuals >65 years. After 25 years of follow-up, there was no relationship between genotype status and any outcome ( P>0.05). H63D/WT and H63D/H63D genotypes were associated with small differences in cardiac remodeling. In conclusion, the HFE H63D variant confers an increased risk for hypertension per allele and, given its frequency, accounts for a significant number of cases of hypertension. However, there was no increased risk for adverse cardiovascular events or substantial left ventricular remodeling.

Night and rotational work exposure within the last 12 months and risk of incident hypertension.

Objectives Shift work, such as alternating day and nights, causes chronobiologic disruptions which may cause an increase in hypertension risk. However, the relative contributions of the components of shift work ‒ such as shift type (eg, night work) and rotations (ie, switching of shift times; day to night) ‒ on this association are not clear. To address this question, we constructed novel definitions of night work and rotational work and assessed their associations with risk of incident hypertension. Methods A cohort of 2151 workers at eight aluminum manufacturing facilities previously studied for cardiovascular disease was followed from 2003 through 2013 for incident hypertension, as defined by ICD-9 insurance claims codes. Detailed time-registry data was used to classify each worker's history of rotational and night work. The associations between recent rotational work and night work in the last 12 months and incident hypertension were estimated using adjusted Cox proportional hazards models. Results Elevated hazard ratios (HR) were observed for all levels of recent night work (>0-5, >5-50, >50-95, >95-100%) compared with non-night workers, and among all levels of rotational work (<1, 1-10, >10-20, >20-30, and >30%) compared with those working <1% rotational work. In models for considering the combination of night and rotational work, workers with mostly night work and frequent rotations (≥50% night and ≥10% rotation) had the highest risk of hypertension compared to non-night workers [HR 4.00, 95% confidence interval (CI )1.69-9.52]. Conclusions Our results suggest recent night and rotational work may both be associated with higher rates of incident hypertension.

Clinical characteristics and risk of hypertension needing treatment in young patients with systolic hypertension identified with ambulatory monitoring.

The clinical significance of isolated systolic hypertension (ISH) in youth is controversial. One main confounding factor is the strong white-coat effect often observed in ISH patients. The aim of this study was to investigate the risk of hypertension needing pharmacological treatment in ISH identified with ambulatory 24-h blood pressure (24-h BP). We examined 1206, 18-45-year-old participants from the Hypertension and Ambulatory Recording VEnetia STudy. Based on 24-h BP, 269 participants were normotensive, 209 had ISH, 277 had isolated diastolic hypertension, and 451 had systolic-diastolic hypertension. The predictive role of ISH for incident hypertension was evaluated in Cox survival analyses, adjusting for risk factors and confounders. ISH participants were more frequently young men active in sports, with lower heart rate and cholesterol. During a 6.9-year follow-up, 61.1% of participants developed hypertension. ISH participants had a nonsignificant increase in risk of hypertension compared with normotensive (reference group). In contrast, participants with diastolic hypertension (1.44; 1.13-1.85) or systolic-diastolic hypertension (2.04; 1.59-2.64) had a significant increase in risk. When the ISH participants were divided according to whether 24-h mean BP was normal (<97 mmHg) or high, ISH patients with normal mean BP had no increase in risk (1.01; 0.73-1.40), whereas those with high mean BP had a significant increase in risk (1.70; 1.16-2.49). These data obtained with ambulatory BP monitoring show that in ISH people younger than 45 years, only mean BP is a predictor of future hypertension needing treatment, whereas the ISH status per se does not necessarily imply an increase in risk.

Causal association of body mass index with hypertension using a Mendelian randomization design.

Observational studies have shown that obesity is a major risk factor for hypertension, but unmeasured confounding factors may exist. We used Mendelian randomization (MR) to assess the causal effect of obesity on hypertension.The MR analysis was performed in a well-defined community cohort study of 8832 middle-aged (40-69 years) adults in Korea enrolled from 2001 to 2013. We used baseline hypertension and newly diagnosed hypertension during the 10-year follow-up period as the outcome variable. Genetic risk score associated with body mass index (BMI GRS) was used as the instrumental variable (IV) to measure the causal relationship between obesity and hypertension. The IV estimate of causal odds ratio (OR) was derived using the Wald ratio estimator and then exponentiation to express the result as an OR.In the multivariable model adjusting for age, sex, study area, education, smoking, and current alcohol consumption, each 1 kg/m increase in BMI was associated with a 19% (OR: 1.19, 95% confidence interval [CI]: 1.17-1.21) increase in hypertension risk. We selected 6 single-nucleotide polymorphisms (P < 1.0 × 10) associated with BMI by genome-wide screening using linear regression and created 6 types of GRS. We demonstrated that each standard-deviation increase in BMI GRS was associated with a 5% to 6% (OR: 1.05-1.06) increased risk of hypertension (all P < .05). Using BMI GRS as the IV, we found a causal relationship between BMI and hypertension (OR: 1.13-1.26, all P < .05 except weighted GRS [n = 6]).Using Mendelian randomization, we found that obesity is causally associated with hypertension. This information will have important public health implications, supporting evidence that obesity-reduction programs will reduce the incidence of hypertension.

GNAI2 polymorphic variance associates with salt sensitivity of blood pressure in the Genetic Epidemiology Network of Salt Sensitivity study.

Salt sensitivity of blood pressure (BP) increases hypertension risk and associated adverse cardiovascular outcomes. At present, there are no validated rapid tests or diagnostic markers to identify salt sensitivity of BP in clinical practice. Based on our prior animal studies that report a role for brain Gαi2 proteins in the salt sensitivity of BP and evidence that GNAI2 single nucleotide polymorphisms (SNPs) associate with hypertension risk, we investigated the hypothesis that GNAI2 SNPs associate with salt sensitivity of BP in humans. Our data provide the first evidence that a GNAI2 SNP (rs10510755) positively associates with salt sensitivity of BP in the Genetic Epidemiology of Salt Sensitivity data set (continuous phenotype P = 0.049, case-control phenotype P = 0.039; n = 968), independently of subject sex or age. These observations suggest that genotyping at GNAI2 may be a useful biomarker in identifying individuals at risk for developing salt-sensitive BP and related complications or in identifying salt sensitivity within the hypertensive population.

Sleep Duration and Hypertension: Analysis of > 700,000 Adults by Age and Sex.

The objective of this study was to evaluate the cross-sectional relationship between sleep duration and hypertension in a large, nationally-representative dataset that spans 10 years. This analysis may provide detailed information with high resolution about how sleep duration is related to hypertension and how this differs by demographic group. Data were aggregated from the 2013 Behavioral Risk Factor Surveillance System (n = 433,386) and the combined 2007-2016 National Health Interview Surveys (n = 295,331). These data were collected by the Centers for Disease Control and Prevention from nationally-representative samples. Surveys were combined, and survey-specific weights were used in all analyses. Sleep duration was assessed with the item, "On average, how many hours of sleep do you get in a 24-hour period?" in both surveys. Hypertension was assessed as self-reported history. Covariates were assessed identically in both datasets and included, age (in 5-year groupings), sex, race/ethnicity, and employment status. In adjusted analyses, compared to 7 hours, increased risk of hypertension was seen among those sleeping ≤ 4 hours (odds ratio [OR] = 1.86, P < .0005), 5 hours (OR = 1.56, P < .0005), 6 hours (OR = 1.27, P < .0005), 9 hours (OR = 1.19, P < .0005), and ≥ 10 hours (OR = 1.41, P < .0005). When stratified by age, sex, and race/ethnicity groups, short sleep was associated with increased risk for all age groups < 70 years, and long sleep (≥ 10 hours only) was associated with risk for all except < 24 years and > 74 years. Findings for short sleep were relatively consistent across all race/ethnicities, although findings for long sleep were less pronounced among Black/African-American and Other/Multiracial groups. A significant sleep by 3-way sleep × age × sex interaction (P < .0005) suggests that the relationship depends on both age and sex. For both men and women, the OR of having hypertension associated with short sleep decreases with increasing age, but there is a higher association between short sleep and hypertension for women, throughout the adult lifespan. Both short and long sleep duration are associated with increased hypertension risk across most age groups. The influence of covariates is stronger upon long sleep relationships. Relationships with short sleep were stronger among younger adults and women.