The Role of Sleep Irregularity in Racial Disparities in Hypertension: The Multi-Ethnic Study of Atherosclerosis (MESA) Öffentlichkeit

Abstract

Background: There are racial differences in hypertension and sleep health, yet the mechanism is unknown. Therefore, we tested whether sleep irregularity contributed to racial differences in hypertension prevalence and control.

 

Methods: Data from the Multi-Ethnic Study of Atherosclerosis was used to evaluate the research question. Sleep irregularity (SD of sleep duration and sleep onset timing) was measured via 7-day actigraphy. Race was self-reported. Hypertension was defined as systolic blood pressure ≥ 130 mm/Hg or diastolic blood pressure ≥80 mm/Hg, antihypertensive medication use, or self-reported physician hypertension diagnosis. Hypertension control was defined as systolic blood pressure <130 mm/Hg and diastolic blood pressure <80 mm/Hg among those with hypertension. Separate logistic regression and linear regression produced odds ratios (OR) and Beta estimates for sleep irregularity by race. Poisson regression produced prevalence ratios (PR) for hypertension and hypertension control by race and sleep irregularity.

 

Results: Participants (n=1393) were 68.8 (SD=9.2) years of age, 46% male, 42% Black, 58% non-Hispanic White, and 48% had a college degree or higher. Average sleep irregularity was 83.4 minutes (SD=42) for sleep duration and 82.2 minutes (SD=94.8) for sleep onset timing. The prevalence of hypertension and hypertension control was 70% and 51% respectively. Black compared to non-Hispanic White adults had higher odds of irregular sleep duration (OR=5.71, 95% CI: 3.15, 10.34) and irregular sleep onset timing (OR=3.19, 95% CI: 2.26, 4.52). There was no association between sleep irregularity and hypertension prevalence or hypertension control. In fully adjusted models, Black compared to non-Hispanic White adults had a 24% higher prevalence of hypertension (PR=1.24, 95% CI: 1.09, 1.42). The association persisted with adjustment for sleep irregularity (categorically and continuously). There was no association between race and hypertension control. Exclusion of those who identified as working an ‘other’ shift and additional adjustments for AHI and average sleep duration produced associations that were consistent with the main analyses.

 

Conclusions: Racial differences in sleep irregularity and hypertension prevalence were observed. Sleep irregularity did not contribute to racial differences in hypertension prevalence or hypertension control. Further studies should evaluate other dimensions of sleep, to determine whether sleep contributes to racial disparities in hypertension.

Table of Contents

Introduction 

Methods 

Results

Discussion

References

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology Health Sciences, Public Health
Stichwort	Racial Disparities Hypertension Sleep Irregularity Sleep Health
Committee Chair / Thesis Advisor	Dayna A. Johnson, Emory University

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