on September 4, 2007
Published online before print September 4, 2007, doi: 10.1161/HYPERTENSIONAHA.107.095471
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Submitted on May 30, 2007
From the Clinical Sciences Research Institute (F.P.C., S.S., N-B.K., M.A.M., F.M.T.), Warwick Medical School, Coventry, United Kingdom; and the International Centre for Health and Society (M.K., J.E.F., M.J.S., E.J.B., M.G.M.), University College London Medical School, London, United Kingdom. * To whom correspondence should be addressed. E-mail: sleepresearch{at}warwick.ac.uk.
Abstract—Sleep deprivation (
Revised on June 24, 2007
Gender-Specific Associations of Short Sleep Duration With Prevalent and Incident Hypertension. The Whitehall II Study
Francesco P. Cappuccio*;
5 hour per night) was associated with a higher risk of hypertension in middle-aged American adults but not among older individuals. However, the outcome was based on self-reported diagnosis of incident hypertension, and no gender-specific analyses were included. We examined cross-sectional and prospective associations of sleep duration with prevalent and incident hypertension in a cohort of 10 308 British civil servants aged 35 to 55 years at baseline (phase 1: 1985–1988). Data were gathered from phase 5 (1997–1999) and phase 7 (2003–2004). Sleep duration and other covariates were assessed at phase 5. At both examinations, hypertension was defined as blood pressure 
140/90 mm Hg or regular use of antihypertensive medications. In cross-sectional analyses at phase 5 (n=5766), short duration of sleep (5 hour per night) was associated with higher risk of hypertension compared with the group sleeping 7 hours, among women (odds ratio: 2.01; 95% CI: 1.13 to 3.58), independent of confounders, with an inverse linear trend across decreasing hours of sleep (P=0.003). No association was detected in men. In prospective analyses (mean follow-up: 5 years), the cumulative incidence of hypertension was 20.0% (n=740) among 3691 normotensive individuals at phase 5. In women, short duration of sleep was associated with a higher risk of hypertension in a reduced model (age and employment) (6 hours per night: odds ratio: 1.56 [95% CI: 1.07 to 2.27]; 5 hour per night: odds ratio: 1.94 [95% CI: 1.08 to 3.50] versus 7 hours). The associations were attenuated after accounting for cardiovascular risk factors and psychiatric comorbidities (odds ratio: 1.42 [95% CI: 0.94 to 2.16]; odds ratio: 1.31 [95% CI: 0.65 to 2.63], respectively). Sleep deprivation may produce detrimental cardiovascular effects among women.
Key words: sleep duration • blood pressure • hypertension • gender differences • confounders • comorbidities
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