Impact of race/ethnicity on the link between sleep duration and hypertension

Introduction: Evidence suggests that short sleep is associated with an increased risk of hypertension. Blacks are more likely to report short sleep (<6hrs) or long sleep (>8hrs) and are characterized by a greater prevalence of hypertension. We examined this differential link between sleep and hypertension using data from the 2009 National Health Interview Survey (NHIS).

Methods: Participants' ranged 18-85 years. 87% were white, 13%, black; 55% were women. The NHIS is a cross-sectional interview survey, spanning the civilian population of all 50 states and DC. Respondents (n=25,352) provided socio-demographic, subjective data and data on physician-diagnosed chronic conditions. They also estimated their habitual sleep duration. Analysis focused on race/ethnicity effects on associations between sleep duration and hypertension.

Results: Compared with individuals of the white race/ethnicity, a greater prevalence of overweight/obesity [OR=1.42, p<0.0001], hypertension [OR=1.40, p<0.0001], and diabetes [OR=1.60, p<0.0001] was observed for individuals of the black race/ethnicity. However, blacks had a lower prevalence of heart disease [OR=0.74, p<0.0001]. Logistic regression analysis indicated that black short or long sleepers were more likely to have hypertension than their white counterparts [OR=1.43, p<0.0001; OR=1.80, p<0.0001], respectively. Adjusting for effects of age, sex, education, obesity, diabetes, and heart disease increased risk of hypertension for black short sleepers [OR=1.66, p<0.0001], but not long sleepers [OR=1.78, p<0.0001].

Conclusion: Our finding of greater risk of hypertension for individuals of the black race/ethnicity, relative to whites, is consistent with data on short sleep and metabolic conditions. In addition they suggest that risk of hypertension may also be greater among black long sleepers.