Associations of Sleep Quality and Awake Physical Activity with Fluctuations in Nocturnal Blood Pressure in Patients with Cardiovascular Risk Factors.
Associations of Sleep Quality and Awake Physical Activity with Fluctuations in Nocturnal Blood Pressure in Patients with Cardiovascular Risk Factors.
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DOI：
10.1371/journal.pone.0155116
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Namba M
中科院分区：
文献类型：
--
作者：
Kadoya M;Koyama H;Kurajoh M;Naka M;Miyoshi A;Kanzaki A;Kakutani M;Shoji T;Moriwaki Y;Yamamoto T;Inaba M;Namba M
睡眠质量和清醒时的身体活动是参与心血管疾病发生的重要行为因素，可能通过夜间血压（BP）的变化。然而，定量测量的睡眠质量和清醒体力活动对血压波动的影响，以及它们与夜间高血压的几个候选病因的关系尚未得到很好的阐明。本横断面研究包括303例在HSCAA研究中登记的患者。测量包括定量测定的睡眠质量参数和通过活动记录仪获得的清醒体力活动、夜间收缩压（SBP）下降[100 ×（1-睡眠收缩压/清醒收缩压比值）]、呼吸暂停低通气指数、尿钠和皮质醇分泌、血浆醛固酮浓度和肾素活性、胰岛素抵抗指数、心率变异性参数（HRV）和血浆脑源性神经营养因子（BDNF）。简单回归分析显示，睡眠质量参数醒后时间（r = -0.150）和清醒时体力活动（r = 0.164）与夜间收缩压下降显著相关。其中，睡眠后清醒时间（β = -0.179）和清醒时体力活动（β = 0.190）与夜间收缩压下降有显著独立相关。在未服用抗高血压药物的患者亚组中，睡眠后清醒时间（β = -0.336）和清醒时的身体活动（β = 0.489）与夜间收缩压下降的相关性更强且独立。研究发现，睡眠质量和清醒时的身体活动与夜间收缩压下降显著相关，这种关系并不一定会被夜间高血压的候选因果因素所混淆。
Sleep quality and awake physical activity are important behavioral factors involved in the occurrence of cardiovascular diseases, potentially through nocturnal blood pressure (BP) changes. However, the impacts of quantitatively measured sleep quality and awake physical activity on BP fluctuation, and their relationships with several candidate causal factors for nocturnal hypertension are not well elucidated. This cross-sectional study included 303 patients registered in the HSCAA study. Measurements included quantitatively determined sleep quality parameters and awake physical activity obtained by actigraph, nocturnal systolic BP (SBP) fall [100 × (1- sleep SBP/awake SBP ratio)], apnea hypopnea index, urinary sodium and cortisol secretion, plasma aldosterone concentration and renin activity, insulin resistance index, parameters of heart rate variability (HRV), and plasma brain-derived neurotrophic factor (BDNF). Simple regression analysis showed that time awake after sleep onset (r = -0.150), a parameter of sleep quality, and awake physical activity (r = 0.164) were significantly correlated with nocturnal SBP fall. Among those, time awake after sleep onset (β = -0.179) and awake physical activity (β = 0.190) were significantly and independently associated with nocturnal SBP fall in multiple regression analysis. In a subgroup of patients without taking anti-hypertensive medications, both time awake after sleep onset (β = -0.336) and awake physical activity (β = 0.489) were more strongly and independently associated with nocturnal SBP falls. Sleep quality and awake physical activity were found to be significantly associated with nocturnal SBP fall, and that relationship was not necessarily confounded by candidate causal factors for nocturnal hypertension.