Key takeaways:

• Short sleep is associated with increased risk for incident hypertension, especially for women.
• There was no association between long sleep duration and hypertension risk.

ATLANTA — Adults who sleep fewer than 7 hours per night are more likely to develop hypertension over time, with greater risk observed for women vs. men, researchers reported at the American College of Cardiology Scientific Session.

“The motivation behind conducting this study stemmed from the significant impact of hypertension as a preventable risk factor for various health conditions, particularly CVD,” Aayushi Sood, MD, a resident at The Wright Center for Graduate Medical Education in Scranton, Pennsylvania, told Healio. “Despite advancements in understanding and managing hypertension, its prevalence has been increasing globally. We wanted to assess how something as simple as sleep could be contributing to hypertension burden.”

Sood and colleagues analyzed data from 16 cohort studies published from 2000 to May 2023 that evaluated the association between self-reported sleep duration and hypertension incidence among 1,044,035 adults who did not have hypertension at baseline. Follow-up duration ranged from 2.4 to 18 years (median follow-up, 5 years). The age of participants ranged from 35 to 61 years and 61% were women.

The researchers found that short sleep duration was associated with higher risk for developing hypertension (HR = 1.07; 95% CI, 1.06-1.09), and the association was more pronounced in those who reported sleeping fewer than 5 hours per night (HR = 1.11; 95% CI, 1.08-1.14).

In analyses stratified by sex, women were more likely than men to develop hypertension with short sleep (HR = 1.07; 95% CI, 1.04-1.09). Results did not change in analyses stratified by age or follow-up duration, and the researchers did not observe any association between long sleep duration and hypertension incidence.

Aayushi Sood

“While the association between short sleep duration and hypertension risk was not entirely surprising based on existing literature, the degree of risk, especially for females, was notable,” Sood told Healio. “The higher risk for women compared with men may be attributed to several factors, including hormonal differences, variations in neurohormonal responses to sleep patterns, and potential interactions with other CV risk factors that may affect females differently.”
Sood said more research is needed on the underlying mechanisms linking sleep duration with hypertension, exploring interventions to improve sleep quality and duration, and conducting longitudinal studies to assess the long-term impact of sleep patterns on CV outcomes. The researchers noted that a limitation of the study is sleep duration was based on self-reported questionnaires and changes in sleep duration during follow-up were not assessed. The definition of short sleep also varied by study (fewer than 5 or 6 hours).

“Additionally, investigating the role of lifestyle factors and psychological stressors in mediating the sleep/BP relationship would be valuable, as well as a better understanding of the sex-based results in the study,” Sood told Healio.