Association between sleep duration and the prevalence of hypertension in middle-aged and elderly Chinese——Based on the data of CHARLS 2018
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摘要:
目的 探究中国中老年人群睡眠时间与高血压患病率的关联。 方法 采用横断面研究分析方法，数据来源北京大学中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS)。共纳入7 885名研究对象，按照夜间睡眠时长分为5组：≤5 h、＞5~ < 6 h、6~ < 7 h(参照)、7~ < 8 h、≥8 h。采用多因素Logistic回归分析模型分析并建立3个模型，在调整不同协变量下逐步探索不同夜间睡眠时长对高血压发生的影响，获得OR值和95% CI值。 结果 以夜间睡眠时长6~ < 7 h为对照，夜间睡眠时长≤5 h患高血压风险较高(OR=1.37, 95% CI: 1.12~1.69, P=0.002)。进一步按照性别分层分析，逐步调整混杂后，男性睡眠时长≤5 h组患高血压的风险是6~ < 7 h组的1.72倍(95% CI: 1.14~2.59, P=0.009)。而在女性中，调整混杂后并未发现关联(OR=1.26, 95% CI: 0.99~1.59, P=0.055)。 结论 在中国中老年人群中，夜间睡眠时长≤5 h可能是高血压患病的独立危险因素，男性夜间睡眠时长≤5 h会增加高血压的患病风险。 -
关键词:
- 睡眠时间 /
- 睡眠 /
- 高血压 /
- 相关性 /
- CHARLS 2018
Abstract:Objective To explore the relationship between sleep duration and the prevalence of hypertension in middle-aged and elderly Chinese. Methods The cross-sectional study method was applied to analyze the data from the China Health and Retirement Longitudinal Study (CHARLS) of Peking University. A total of 7 885 subjects were included in this study. According to nocturnal sleep duration, the subjects were divided into 5 groups: ≤5 h, > 5- < 6 h, 6- < 7 h(reference), 7- < 8 h, ≥8 h. Using binary Logistic regression analysis, we established three models to explore the association between nocturnal sleep duration and the prevalence of hypertension by adjusting different covariates and odds ratio (OR) and 95% confidence interval (95% CI) were obtained. Results Taking nocturnal sleep duration 6- < 7 h as reference, the risk of hypertension among nocturnal sleep duration ≤5 h was 1.37 times higher(95% CI: 1.12-1.69, P=0.002). Further, subjects were classified according to gender. After adjusting for confounders with step-by-step method, the risk of hypertension in males with nocturnal sleep duration ≤5 h group was 1.72 times higher than with nocturnal sleep duration 6- < 7 h (95% CI: 1.14-2.59, P=0.009). However, no association was found in females after adjusting for confounders (OR=1.26, 95% CI: 0.99-1.59, P=0.055). Conclusions In Chinese middle aged and elderly people, nocturnal sleep duration ≤5 h may be an independent risk factor for hypertension. And for males, nocturnal sleep duration ≤5 h can increase the risk of hypertension. -
Key words:
- Sleep duration /
- Sleep /
- Hypertension /
- Association /
- CHARLS 2018
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表 1 不同睡眠时长人群的人口统计学信息[n(%)]
Table 1. Demographic information of people with different sleep duration [n(%)]
因素 ≤5 h ＞5~ < 6 h 6~ < 7 h 7~ < 8 h ≥8 h F/χ2/H值 P值 夜晚睡眠时长[h, (x±s)] 4.00±1.15 5.96±0.13 6.94±410.16 7.96±0.14 9.72±1.39 10 899.64 ＜0.001 午间睡眠时长[min, (x±s)] 31.69±40.13 37.71±41.04 41.64±40.77 41.99±43.54 45.35±45.66 20.86 0.000 年龄[岁, (x±s)] 63.10±10.24 60.20±9.59 59.81±9.63 60.11±10.27 63.08±11.71 43.21 ＜0.001 性别 52.46 ＜0.001 男 437(17.45) 380(22.57) 363(25.28) 386(25.28) 183(24.97) 女 2 068(82.55) 1 304(77.43) 1 073(74.72) 1 141(74.72) 550(75.03) 受教育程度 205.43 ＜0.001 未完成小学 1 325(52.89) 668(39.67) 526(36.63) 1 031(48.34) 443(60.44) 小学/初中 943(37.64) 751(44.60) 650(45.26) 888(41.63) 241(32.88) 高中/中专/大专 228(9.10) 240(14.25) 232(16.16) 203(9.52) 47(6.41) 本科及以上 9(0.36) 25(1.48) 28(1.95) 11(0.52) 2(0.27) 婚姻状况 103.53 ＜0.001 在婚 2 055(82.04) 1 515(89.96) 1 271(88.51) 1 370(89.72) 598(81.58) 离异 34(1.36) 12(0.71) 20(1.39) 16(1.05) 12(1.64) 丧偶 407(16.25) 153(9.09) 140(9.75) 139(9.10) 116(15.83) 从未结婚 9(0.36) 4(0.24) 5(0.35) 2(0.13) 7(0.59) 居住地 148.35 ＜0.001 城市 487(19.44) 425(25.24) 404(28.13) 296(19 38) 92(12.55) 城乡交界 197(7.86) 170(10.10) 140(9.75) 143(9.36) 31(4.23) 乡村 1 813(72.38) 1 077(63.95) 883(61.49) 1 077(70.53) 602(82.13) 特殊 8(0.32) 12(0.71) 9(0.63) 11(0.72) 8(1.09) 是否锻炼 43.18 ＜0.001 不锻炼 263(10.50) 116(6.89) 88(6.13) 115(7.53) 89(12.14) 锻炼 2 242(89.50) 1 568(93.11) 1 348(93.87) 1 412(92.47) 644(87.86) 是否吸烟 16.71 0.033 现在吸烟 82(3.27) 73(4.33) 69(4.81) 85(5.57) 39(5.32) 从不吸烟 2 343(93.53) 1 546(91.81) 1 324(92.20) 1 390(91.03) 670(91.41) 过去吸烟 80(3.19) 65(3.86) 43(2.99) 52(3.41) 24(3.27) 是否饮酒 12.98 ＜0.001 每个月超过一次 356(14.21) 304(18.05) 248(17.27) 249(16.31) 115(15.69) 每个月不超过一次 186(7.43) 136(8.08) 140(9.75) 100(6.55) 43(5.87) 从不饮酒 1 963(78.36) 1 244(73.87) 1 048(72.98) 1 178(77.14) 575(78.44) 合计 2 505(31.77) 1 684(21.36) 1 436(18.21) 1 527(19.37) 733(9.30) 
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表 2 高血压分布人群的人口统计学信息[n(%)]
Table 2. Demographic information of people with hypertension [n(%)]
变量 高血压 χ2/H值 P值 变量 高血压 χ2/H值 P值 有 无 有 无 年龄(岁) 85.47 ＜0.001 是否锻炼 8.21 0.004 < 45 4(0.39) 89(1.30) 不锻炼 111(10.84) 560(8.16) 45~ < 55 197(19.24) 2 079(30.30) 锻炼 913(89.16) 6 301(91.84) 55~ < 65 331(32.32) 2 381(34.70) 是否吸烟 60.21 ＜0.001 ≥65 492(48.05) 2 312(33.70) 现在吸烟 61(5.96) 287(4.18) 性别 24.88 ＜0.001 从不吸烟 890(86.91) 6 383(93.03) 男 289(28.22) 1 460(21.28) 过去吸烟 73(7.13) 191(2.78) 女 735(71.78) 5 410(78.72) 是否饮酒 0.21 0.645 受教育程度 7.62 0.006 每个月超过一次 180(17.58) 1 092(15.92) 未完成小学 508(49.61) 3 082(44.92) 每个月不超过一次 69(6.74) 536(7.81) 小学/初中 408(39.84) 2 894(42.18) 从不饮酒 775(75.68) 5 233(76.27) 高中/中专/大专 97(9.47) 821(11.97) 本科及以上 11(1.07) 64(0.93) 夜间睡眠时长(h) 7.95 0.005 婚姻状况 27.65 ＜0.001 ≤5 388(37.89) 2 117(30.86) 在婚 831(81.15) 5 978(87.13) ＞5~ < 6 190(18.55) 1 494(21.78) 离异 15(1.46) 79(1.15) 6~ < 7 158(15.43) 1 278(18.63) 丧偶 174(16.99) 781(11.38) 7~ < 8 192(18.75) 1 335(19.46) 从未结婚 4(0.39) 23(0.34) ≥8 96(9.38) 637(9.28) 居住地 1.90 0.594 午间睡眠时长(min) 8.91 0.003 城市 208(20.31) 1 496(21.00) 0 384(37.50) 2 898(42.24) 城乡交界 83(8.11) 598(8.72) ＞0~ < 30 137(13.38) 962(14.02) 乡村 727(71.00) 4 725(68.87) ≥30 503(49.12) 3 001(43.74) 特殊 6(0.59) 42(0.61)
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表 3 睡眠时长与高血压患病关联的Logistic回归分析模型分析
Table 3. Logistic regression analysis of the relationship between sleep duration and hypertension
睡眠时长(h) OR(95% CI)值 Z值 sx值 P值 未调整模型 ≤5 1.37(1.22~1.81) 3.03 0.14 ＜0.001 ＞5~ < 6 1.03(0.82~1.29) 0.26 0.11 0.805 6~ < 7 1.00 7~ < 8 1.14(0.93~1.46) 1.13 0.13 0.186 ≥8 1.06(0.93~1.60) 0.38 0.15 0.152 模型1 a ≤5 1.37(1.12~1.67) 3.03 0.14 0.002 ＞5~ < 6 1.03(0.82~1.29) 0.26 0.12 0.798 6~ < 7 1.00 7~ < 8 1.14(0.91~1.43) 1.13 0.13 0.259 ≥8 1.06(0.80~1.39) 0.38 0.15 0.701 模型2 b ≤5 1.37(1.12~1.69) 3.08 0.14 0.002 ＞5~ < 6 1.02(0.81~1.27) 0.17 0.12 0.862 6~ < 7 1.00 7~ < 8 1.13(0.90~1.42) 1.04 0.13 0.298 ≥8 1.04(0.79~1.38) 0.29 0.15 0.770 注：a调整性别、年龄、居住地、婚姻状况、受教育程度; b调整性别、年龄、居住地、婚姻状况、受教育程度、锻炼、吸烟、饮酒、午间睡眠时长。
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表 4 睡眠时长与高血压患病关联按性别分层Logistic回归分析模型分析
Table 4. Logistic regression of the association between sleep duration and hypertension by gender
睡眠时长(h) 男性 女性 OR(95% CI)值 Z值 sx值 P值 OR(95% CI)值 Z值 sx值 P值 未调整模型 ≤5 1.88(1.26~2.79) 3.12 0.38 0.002 1.41(1.12~1.78) 2.96 0.17 0.003 ＞5~ < 6 1.23(0.80~1.89) 0.96 0.27 0.339 0.97(0.75~1.26) -0.23 0.13 0.820 6~ < 7 1.00 1.00 7~ < 8 1.62(1.07~2.44) 2.30 0.34 0.022 1.01(0.77~1.32) 0.05 0.14 0.962 ≥8 1.76(1.08~2.86) 2.28 0.44 0.023 1.04(0.75~1.44) 0.23 0.17 0.819 模型1 a ≤5 1.79(1.20~2.68) 2.84 0.37 0.005 1.23(0.97~1.55) 1.71 0.15 0.087 ＞5~ < 6 1.22(1.79~1.88) 0.90 0.27 0.370 0.95(0.73~1.24) -0.34 0.13 0.731 6~ < 7 1.00 1.00 7~ < 8 1.64(1.08~2.49) 2.32 0.35 0.020 0.99(0.75~1.30) -0.08 0.14 0.937 ≥8 1.63(0.99~2.68) 1.91 0.41 0.057 0.88(0.63~1.24) -0.72 0.15 0.474 模型2 b ≤5 1.72(1.14~2.59) 2.61 0.36 0.009 1.26(0.99~1.59) 1.92 0.15 0.055 ＞5~ < 6 1.15(0.74~1.78) 0.63 0.26 0.526 0.96(0.74~1.26) -0.27 0.13 0.787 6~ < 7 1.00 1.00 7~ < 8 1.58(1.04~2.41) 2.14 0.34 0.033 0.99(0.75~1.30) -0.07 0.14 0.946 ≥8 1.54(0.93~2.56) 1.68 0.40 0.094 0.89(0.63~1.24) -0.71 0.15 0.478 注：a调整性别、年龄、居住地、婚姻状况、受教育程度; b调整性别、年龄、居住地、婚姻状况、受教育程度、锻炼、吸烟、饮酒、午间睡眠时长。
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