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Short sleep duration linked to increased cardiovascular risk

Arch Intern Med 2008; 168: 2225–2231

Short sleep duration is an independent predictor of cardiovascular disease (CVD) in patients with hypertension, research suggests.

Kazuo Eguchi (Jichi Medical University, Tochigi, Japan) and colleagues found that sleeping less than 7.5 hours per night is associated with increased risk for future cardiovascular (CV) events. In addition, a combination of reduced sleep duration and elevated overnight blood pressure (BP) appears to increase the risk further.

Short duration of sleep has previously been linked to obesity, diabetes, hypertension, and sleep apnea, and has been shown to increase overall mortality. However, this is the first study to examine the effects of sleep duration on CV events in healthy elderly patients.

Ambulatory BP was evaluated in 1255 Japanese individuals (mean age, 70.4 years) who were referred to nine medical centers for monitoring of asymptomatic hypertension. Sleep duration was diary-assessed and the cut-off value was set at 7.5 hours, based on previous studies showing that 7–8 hours sleep had the lowest risk for CV events.

During the follow-up period (mean, 55 months), three CV outcomes were assessed: stroke, fatal or nonfatal myocardial infarction, and sudden cardiac death. In total, 99 events occurred. The incidence was 2.4 per 100 person–years in subjects with less than 7.5 hours sleep, compared with 1.8 per 100 person–years in those with longer duration of sleep.

Dividing the patients into four groups of long and short sleep duration with/without an overnight increase in BP demonstrated that only those with less than 7.5 hours sleep with an overnight rise in BP had an increase in CV events. There was a 4.4-fold increase in events in this group compared with those with longer sleep duration and no rise in BP.

The authors comment that “this is the first report showing the prognostic importance of shorter sleep duration in combination with the nocturnal BP dipping pattern as a risk for incident CVD”.

They therefore recommend that “physicians should inquire about sleep duration in the risk assessment of patients with hypertension.”

The research is published in the Archives of Internal Medicine.

Read the abstract