Association between insomnia and hypertension: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

YE Yuanyuan ¹ , LIU Juan ² ,  LI Wentao ¹

1. Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P. R. China;
2. Army Medical Center of PLA, Chongqing 400010, P. R. China;

Corresponding author：

LI Wentao, Email: lwt1132@163.com

Keywords：

Insomnia; Hypertension; Meta-analysis; Systematic review; Cohort study

DOI：

10.7507/1672-2531.202203033

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the association between insomnia and the risk of hypertension. Methods The EMbase, PubMed, The Cochrane Library, VIP, WanFang Data and CNKI databases were electronically searched to collect cohort studies on the association between insomnia and hypertension from inception to October 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 13.0 software. Results A total of 20 cohort studies involving 607 409 participants were included. The results of meta-analysis showed that insomnia increased the risk of hypertension (RR=1.24, 95%CI 1.15 to 1.34, P<0.000 1). Subgroup analysis showed that insomnia increased the risk of hypertension in North American, European and Oceanian population, but not in Asian population. The difficulty falling asleep, difficulty maintaining sleep and early awakening all increased the risk of hypertension. Conclusion Current evidence suggests that insomnia increases the risk of hypertension.

Citation： YE Yuanyuan, LIU Juan, LI Wentao. Association between insomnia and hypertension: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2022, 22(7): 822-828. doi: 10.7507/1672-2531.202203033 Copy

1.	Slivnick J, Lampert BC. Hypertension and heart failure. Heart Fail Clin, 2019, 15(4): 531-541.
2.	于思雨, 邱桦, 吴抗, 等. 上海市浦东新区15岁及以上居民高血压发病危险因素的队列研究. 中国慢性病预防与控制, 2020, 28(3): 205-209.
3.	Ostroumova TM, Parfenov VA, Ostroumova OD, et al. Hypertension and insomnia. Ter Arkh, 2020, 92(1): 69-75.
4.	Bollu PC, Kaur H. Sleep medicine: insomnia and sleep. Mo Med, 2019, 116(1): 68-75.
5.	Thomas SJ, Calhoun D. Sleep, insomnia, and hypertension: current findings and future directions. J Am Soc Hypertens, 2017, 11(2): 122-129.
6.	杨兰芳. 睡眠时间与高血压发病风险前瞻性研究的Meta分析. 福州: 福建医科大学, 2017.
7.	Jarrin DC, Alvaro PK, Bouchard MA, et al. Insomnia and hypertension: a systematic review. Sleep Med Rev, 2018, 41: 3-38.
8.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
9.	Cheng P, Pillai V, Mengel H, et al. Sleep maintenance difficulties in insomnia are associated with increased incidence of hypertension. Sleep Health, 2015, 1(1): 50-54.
10.	Clark AJ, Salo P, Lange T, et al. Onset of impaired sleep and cardiovascular disease risk factors: a longitudinal study. Sleep, 2016, 39(9): 1709-1718.
11.	Deng HB, Tam T, Zee BC, et al. Short sleep duration increases metabolic impact in healthy adults: a population-based cohort study. Sleep, 2017, 40(10): 103.
12.	Dong Y, Yang FM. Insomnia symptoms predict both future hypertension and depression. Prev Med, 2019, 123: 41-47.
13.	Duncan MJ, Holliday EG, Oftedal S, et al. Joint association of physical activity and sleep difficulties with the incidence of hypertension in mid-age Australian women. Maturitas, 2021, 149: 1-7.
14.	Fernandez-Mendoza J, Vgontzas AN, Liao D, et al. Insomnia with objective short sleep duration and incident hypertension: the Penn State Cohort. Hypertension, 2012, 60(4): 929-935.
15.	Gangwisch JE, Malaspina D, Posner K, et al. Insomnia and sleep duration as mediators of the relationship between depression and hypertension incidence. Am J Hypertens, 2010, 23(1): 62-69.
16.	Haaramo P, Rahkonen O, Hublin C, et al. Insomnia symptoms and subsequent cardiovascular medication: a register-linked follow-up study among middle-aged employees. J Sleep Res, 2014, 23(3): 281-289.
17.	Leigh L, Hudson IL, Byles JE. Sleep difficulty and disease in a cohort of very old women. J Aging Health, 2016, 28(6): 1090-1104.
18.	Lewis PE, Emasealu OV, Rohrbeck P, et al. Risk of type Ⅱ diabetes and hypertension associated with chronic insomnia among active component, U. S. Armed Forces, 1998-2013. MSMR, 2014, 21(10): 6-13.
19.	Li X, Sotres-Alvarez D, Gallo LC, et al. Associations of sleep-disordered breathing and insomnia with incident hypertension and diabetes. The Hispanic community health study/study of Latinos. Am J Respir Crit Care Med, 2021, 203(3): 356-365.
20.	Lin CL, Liu TC, Lin FH, et al. Association between sleep disorders and hypertension in Taiwan in China: a nationwide population-based retrospective cohort study. J Hum Hypertens, 2017, 31(3): 220-224.
21.	Lunyera J, Park YM, Ward JB, et al. A prospective study of multiple sleep dimensions and hypertension risk among white, black and Hispanic/Latina women: findings from the Sister Study. J Hypertens, 2021, 39(11): 2210-2219.
22.	Pedraza S, Al Snih S, Ottenbacher KJ, et al. Sleep quality and sleep problems in Mexican Americans aged 75 and older. Aging Clin Exp Res, 2012, 24(4): 391-397.
23.	Phillips B, Mannino DM. Do insomnia complaints cause hypertension or cardiovascular disease. J Clin Sleep Med, 2007, 3(5): 489-494.
24.	Phillips B, Bůzková P, Enright P, et al. Insomnia did not predict incident hypertension in older adults in the cardiovascular health study. Sleep, 2009, 32(1): 65-72.
25.	Rod NH, Vahtera J, Westerlund H, et al. Sleep disturbances and cause-specific mortality: Results from the GAZEL cohort study. Am J Epidemiol, 2011, 173(3): 300-309.
26.	Sivertsen B, Lallukka T, Salo P, et al. Insomnia as a risk factor for ill health: results from the large population-based prospective HUNT Study in Norway. J Sleep Res, 2014, 23(2): 124-132.
27.	Suka M, Yoshida K, Sugimori H. Persistent insomnia is a predictor of hypertension in Japanese male workers. J Occup Health, 2003, 45(6): 344-350.
28.	Troxel WM, Buysse DJ, Matthews KA, et al. Sleep symptoms predict the development of the metabolic syndrome. Sleep, 2010, 33(12): 1633-1640.
29.	Patel D, Steinberg J, Patel P. Insomnia in the elderly: a review. J Clin Sleep Med, 2018, 14(6): 1017-1024.
30.	Oliveros E, Patel H, Kyung S, et al. Hypertension in older adults: assessment, management, and challenges. Clin Cardiol, 2020, 43(2): 99-107.
31.	Rezaie L, Fobian AD, McCall WV, et al. Paradoxical insomnia and subjective-objective sleep discrepancy: a review. Sleep Med Rev, 2018, 40: 196-202.
32.	Gaffey AE, Redeker NS, Rosman L, et al. The role of insomnia in the association between posttraumatic stress disorder and hypertension. J Hypertens, 2020, 38(4): 641-648.
33.	Kokubo Y, Matsumoto C. Hypertension is a risk factor for several types of heart disease: review of prospective studies. Adv Exp Med Biol, 2017, 956: 419-426.
34.	Hester J, Ventetuolo C, Lahm T. Sex, gender, and sex hormones in pulmonary hypertension and right ventricular failure. Compr Physiol, 2019, 10(1): 125-170.

1. Slivnick J, Lampert BC. Hypertension and heart failure. Heart Fail Clin, 2019, 15(4): 531-541.
2. 于思雨, 邱桦, 吴抗, 等. 上海市浦东新区15岁及以上居民高血压发病危险因素的队列研究. 中国慢性病预防与控制, 2020, 28(3): 205-209.
3. Ostroumova TM, Parfenov VA, Ostroumova OD, et al. Hypertension and insomnia. Ter Arkh, 2020, 92(1): 69-75.
4. Bollu PC, Kaur H. Sleep medicine: insomnia and sleep. Mo Med, 2019, 116(1): 68-75.
5. Thomas SJ, Calhoun D. Sleep, insomnia, and hypertension: current findings and future directions. J Am Soc Hypertens, 2017, 11(2): 122-129.
6. 杨兰芳. 睡眠时间与高血压发病风险前瞻性研究的Meta分析. 福州: 福建医科大学, 2017.
7. Jarrin DC, Alvaro PK, Bouchard MA, et al. Insomnia and hypertension: a systematic review. Sleep Med Rev, 2018, 41: 3-38.
8. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
9. Cheng P, Pillai V, Mengel H, et al. Sleep maintenance difficulties in insomnia are associated with increased incidence of hypertension. Sleep Health, 2015, 1(1): 50-54.
10. Clark AJ, Salo P, Lange T, et al. Onset of impaired sleep and cardiovascular disease risk factors: a longitudinal study. Sleep, 2016, 39(9): 1709-1718.
11. Deng HB, Tam T, Zee BC, et al. Short sleep duration increases metabolic impact in healthy adults: a population-based cohort study. Sleep, 2017, 40(10): 103.
12. Dong Y, Yang FM. Insomnia symptoms predict both future hypertension and depression. Prev Med, 2019, 123: 41-47.
13. Duncan MJ, Holliday EG, Oftedal S, et al. Joint association of physical activity and sleep difficulties with the incidence of hypertension in mid-age Australian women. Maturitas, 2021, 149: 1-7.
14. Fernandez-Mendoza J, Vgontzas AN, Liao D, et al. Insomnia with objective short sleep duration and incident hypertension: the Penn State Cohort. Hypertension, 2012, 60(4): 929-935.
15. Gangwisch JE, Malaspina D, Posner K, et al. Insomnia and sleep duration as mediators of the relationship between depression and hypertension incidence. Am J Hypertens, 2010, 23(1): 62-69.
16. Haaramo P, Rahkonen O, Hublin C, et al. Insomnia symptoms and subsequent cardiovascular medication: a register-linked follow-up study among middle-aged employees. J Sleep Res, 2014, 23(3): 281-289.
17. Leigh L, Hudson IL, Byles JE. Sleep difficulty and disease in a cohort of very old women. J Aging Health, 2016, 28(6): 1090-1104.
18. Lewis PE, Emasealu OV, Rohrbeck P, et al. Risk of type Ⅱ diabetes and hypertension associated with chronic insomnia among active component, U. S. Armed Forces, 1998-2013. MSMR, 2014, 21(10): 6-13.
19. Li X, Sotres-Alvarez D, Gallo LC, et al. Associations of sleep-disordered breathing and insomnia with incident hypertension and diabetes. The Hispanic community health study/study of Latinos. Am J Respir Crit Care Med, 2021, 203(3): 356-365.
20. Lin CL, Liu TC, Lin FH, et al. Association between sleep disorders and hypertension in Taiwan in China: a nationwide population-based retrospective cohort study. J Hum Hypertens, 2017, 31(3): 220-224.
21. Lunyera J, Park YM, Ward JB, et al. A prospective study of multiple sleep dimensions and hypertension risk among white, black and Hispanic/Latina women: findings from the Sister Study. J Hypertens, 2021, 39(11): 2210-2219.
22. Pedraza S, Al Snih S, Ottenbacher KJ, et al. Sleep quality and sleep problems in Mexican Americans aged 75 and older. Aging Clin Exp Res, 2012, 24(4): 391-397.
23. Phillips B, Mannino DM. Do insomnia complaints cause hypertension or cardiovascular disease. J Clin Sleep Med, 2007, 3(5): 489-494.
24. Phillips B, Bůzková P, Enright P, et al. Insomnia did not predict incident hypertension in older adults in the cardiovascular health study. Sleep, 2009, 32(1): 65-72.
25. Rod NH, Vahtera J, Westerlund H, et al. Sleep disturbances and cause-specific mortality: Results from the GAZEL cohort study. Am J Epidemiol, 2011, 173(3): 300-309.
26. Sivertsen B, Lallukka T, Salo P, et al. Insomnia as a risk factor for ill health: results from the large population-based prospective HUNT Study in Norway. J Sleep Res, 2014, 23(2): 124-132.
27. Suka M, Yoshida K, Sugimori H. Persistent insomnia is a predictor of hypertension in Japanese male workers. J Occup Health, 2003, 45(6): 344-350.
28. Troxel WM, Buysse DJ, Matthews KA, et al. Sleep symptoms predict the development of the metabolic syndrome. Sleep, 2010, 33(12): 1633-1640.
29. Patel D, Steinberg J, Patel P. Insomnia in the elderly: a review. J Clin Sleep Med, 2018, 14(6): 1017-1024.
30. Oliveros E, Patel H, Kyung S, et al. Hypertension in older adults: assessment, management, and challenges. Clin Cardiol, 2020, 43(2): 99-107.
31. Rezaie L, Fobian AD, McCall WV, et al. Paradoxical insomnia and subjective-objective sleep discrepancy: a review. Sleep Med Rev, 2018, 40: 196-202.
32. Gaffey AE, Redeker NS, Rosman L, et al. The role of insomnia in the association between posttraumatic stress disorder and hypertension. J Hypertens, 2020, 38(4): 641-648.
33. Kokubo Y, Matsumoto C. Hypertension is a risk factor for several types of heart disease: review of prospective studies. Adv Exp Med Biol, 2017, 956: 419-426.
34. Hester J, Ventetuolo C, Lahm T. Sex, gender, and sex hormones in pulmonary hypertension and right ventricular failure. Compr Physiol, 2019, 10(1): 125-170.

Previous Article
Health economics evaluation of gastric cancer prevention and screening: a systematic review
Next Article
Bibliometric analysis of studies on medical research integrity in China

Chinese Journal of Evidence-Based Medicine

Association between insomnia and hypertension: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content