Abstract 12190: Sleep Duration, Kidney Function, and Their Effects on Silent Cerebral Injury in the Elderly Hypertensives
Background: Short sleep duration has been shown to be associated with cardio/cerebrovascular disease. White matter hyperintensities (WMH) have been associated with increased risk of stroke. Chronic kidney disease (CKD) is a risk factor for white matter hyperintensities. In this study, we investigated the relationships among sleep duration, kidney function and WMH in elderly hypertensives.
Methods: Ambulatory blood pressure (BP) monitoring and Brain magnetic resonance imaging (MRI) were performed in 514 Japanese elderly hypertensives (72.3 years old, male 37%). WMH cases were further devided into deep subcortical white matter lesion (DWML) or periventricular hyperintensity (PVH). CKD was defined as eGFR less than 60 mL/min/1.73m2.
Results: According to the sleep duration (7.5 to 9.5h 9.5h per night), significant associations of sleep duration were observed with WMH (81.9 vs 70.8 vs 80.5 %, p≤0.05) and PVH (78.5 vs 68.2 vs 79.0 %, p≤0.05). In the multiple logistic regression analysis adjustment for confounders including age and 24-hr systolic BP, short sleep duration (≤ 7.5 h per night) was significantly positively associated with WMH (Odds ratio [OR]: 1.88, 95%CI: 1.08-3.28, p≤0.05) and PVH (OR: 1.72, 95%CI: 1.01-2.93, p≤0.05) when subjects with sleep duration with 7.5-9.5 h as a reference group, while CKD was not significantly associated with white matter lesion. A significant interaction was found between short sleep duration and CKD for the PVH (p≤0.05). Especially, in the non-CKD group, short sleep duration had strong significant positive associations with WMH (OR: 2.71, 95%CI: 1.38-5.30, p≤0.01) and PVH (OR: 2.59, 95%CI: 1.36-4.93, p≤0.01).
Conclusions: In the present study, short sleep duration was positively significantly associated with WMH and PVH independently of 24-hr SBP in elderly hypertensives. In addition to the conventional risk factors, sleep duration might serve as a strong determinant for white matter lesion especially in those without CKD.
- © 2013 by American Heart Association, Inc.