Periodic limb movements during sleep and prevalent hypertension in the multi-ethnic study of atherosclerosis.
Periodic limb movements during sleep and prevalent hypertension in the multi-ethnic study of atherosclerosis.
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DOI：
10.1161/hypertensionaha.114.04193
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发表时间：
2015-01
期刊：
影响因子：
--
通讯作者：
Redline S
中科院分区：
文献类型：
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作者：
Koo BB;Sillau S;Dean DA 2nd;Lutsey PL;Redline S
睡眠期间的周期性肢体运动（PLMS）与血压的立即升高有关。PLMS和高血压在种族/民族群体中的分布不同。我们试图确定PLMS是否与不同种族/民族的高血压相关。1，740名男性和女性接受了血压测量和多导睡眠图以及PLMS定量。高血压定义为收缩压（SBP）≥140，舒张压≥90，或服用抗高血压药物。对于服用抗高血压药物的患者，根据观察到的SBP和药物类型/剂量推导出治疗前SBP估计值。测量PLMS，PLMS指数（PLMI）和PLMS唤醒指数（PLMAI），是主要的解释变量。采用logistic和多变量回归模型对高血压和SBP进行建模，校正年龄、性别、体重指数、心血管危险因素、生活方式/习惯因素、呼吸暂停低通气指数和人种/种族。在整个队列中，调整混杂因素后，患病高血压与PLMI（10个单位）（OR 1.05 [95%CI 1.00，1.10]）和PLMAI（1个单位）（1.05 [1.01，1.09]）中度相关。在非裔美国人中，当PLMI增加10个单位时，高血压患病率增加21% [1%，45%];当PLMAI增加1个单位时，高血压患病率增加20% [2%，42%]。在非裔美国人中，PLMAI每增加1个单位与SBP升高1.01 mmHg相关（1.01 [0.04，1.98]）。PLMS和血压结果之间的关联也在华裔美国人中提出，但在白人或西班牙裔中没有。在一个多种族的社区居住的男性和女性队列中，患病的高血压和SBP与非洲裔美国人的PLMS频率相关。
Periodic limb movements during sleep (PLMS) are associated with immediate increases in blood pressure. Both PLMS and hypertension have different distributions across racial/ethnic groups. We sought to determine if PLMS is associated with hypertension among various racial/ethnic groups. 1,740 men and women underwent measurement of blood pressure and polysomnography with quantification of PLMS. Hypertension was defined as systolic blood pressure (SBP)≥140, diastolic BP≥90, or taking anti-hypertensive medication. For those taking anti-hypertensives, an estimated pre-treatment SBP value was derived based on observed SBP and medication type/dose. Measures of PLMS, PLMS index (PLMI) and PLMS arousal index (PLMAI), were the main explanatory variables. Hypertension and SBP were modeled with logistic and multivariable regression adjusted for age, sex, body mass index, cardiovascular risk factors, lifestyle/habitual factors, apnea-hypopnea index, and race/ethnicity. In the overall cohort, prevalent hypertension was modestly associated with PLMI (10-unit) (OR 1.05 [95% CI 1.00,1.10]) and PLMAI (1-unit) (1.05 [1.01,1.09]) after adjusting for confounders. Association in the overall cohort was influenced by large effect sizes in African-Americans, in whom the odds of prevalent hypertension increased by 21% [1%,45%] for 10-unit PLMI increase and 20% [2%,42%] for 1-unit PLMAI increase. In African-Americans, every 1-unit PLMAI increase was associated with SBP 1.01 mmHg higher (1.01 [0.04,1.98]). Associations between PLMS and blood pressure outcomes were also suggested among Chinese-Americans but not in Caucasians or Hispanics. In a multiethnic cohort of community dwelling men and women, prevalent hypertension and SBP are associated with PLMS frequency in African-Americans.