Abstract 17883: Gender Differences in the Association of Poor Sleep Quality with Arterial Stiffness: the META-Health Study
Background: Poor nocturnal sleep quality has been associated with cardiovascular (CVD) morbidity and mortality. This risk may be mediated by nocturnal fluctuations in blood pressure with subsequent impairment in arterial elastic properties. We sought to examine whether sleep quality influences arterial stiffness, and if there are differences based on gender.
Methods: We measured CVD risk factors in 525 participants (mean age 51±9 years, 48% African American, 62% female) enrolled in the Morehouse-Emory Partnership to Eliminate Cardiovascular Health Disparities (META-Health) study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI); a total PSQI score ≥6 (median) was considered poor sleep quality. Central blood pressures and augmentation index (CAIx), a composite measure of arterial wave reflections and stiffness, were estimated using applanation tonometry (SphygmoCor, AtCor Medical). Multiple linear regression was used to adjust for age, race, smoking, hypertension, diabetes, body mass index, mean arterial pressure, heart rate, glucose, and lipid profile.
Results: Participants with poor sleep quality had higher peripheral systolic (123±17 vs. 120±19 mm Hg, p=0.006), peripheral diastolic (79±11 vs. 77±12 mm Hg, p<0.05), and central systolic (116±17 vs. 113±18 mm Hg, p=0.03) blood pressure than those with good sleep quality. In fully adjusted models, the total PSQI score was significantly associated with CAIx (β=0.13, p=0.03) and there was a significant PSQI score*gender interaction (p=0.009). Men with poor sleep quality had a significantly higher CAIx (adjusted for heart rate) than men with good sleep quality (24.5±4.9 vs. 22.6±5.0%, p=0.003); there was no difference in CAIx in women with poor vs. good sleep quality (31.2±4.3 vs. 31.8±3.6%, p=0.4). In fully adjusted gender-stratified models, the total PSQI score remained a significant predictor of higher CAIx in men (β=0.188, p=0.001), but not in women (β=-0.087, p=0.07).
Conclusion: Poor sleep quality is associated with higher blood pressure in both genders, however is only associated with arterial wave reflections and stiffness in men. Improving sleep quality may be a therapeutic target for improving CVD risk, however further investigation is needed.
- © 2010 by American Heart Association, Inc.