The Mediation of Racial Differences in Hypertension by Sleep Characteristics: Chicago Area Sleep Study

Details

• Personal Author:
  Carnethon MR ; De Chavez PJD ; Kershaw KN ; Kim K-YA ; Knutson KL ; Montag SE ; Rasmussen-Torvik LJ ; Zee PC
• Description:
  BACKGROUND: Racial disparities in hypertension prevalence in the United States are established. Given our understanding of racial and ethnic disparities in sleep characteristics and demonstrated associations between sleep characteristics and hypertension, we tested whether sleep characteristics mediated racial disparities in hypertension. METHODS: Analyses were performed in the Chicago Area Sleep Study, a population-based cohort study of 154 Blacks, 128 Whites, 103 Hispanics, and 109 Asians without obstructive sleep apnea. Participants underwent 7 days of wrist actigraphy monitoring. Algorithms were used to determine sleep duration and sleep maintenance (the percent of sleep in the sleep period). Hypertension was determined as systolic blood pressure >140mm Hg or diastolic blood pressure >90mm Hg or the use of antihypertensive medications. We estimated sample prevalence ratios for hypertension before and after adjustment for sleep characteristics and also conducted mediation analysis. RESULTS: The sample prevalence of hypertension was highest in Blacks (36%), followed by Hispanics (14%), Asians (8%), and Whites (5%). The sample prevalence ratio for hypertension for Blacks vs. Whites was 5.52 (95% confidence interval (CI): 2.36, 13.23) after adjusting for age, sex, and education. Adjustment for sleep duration had no influence on the effect estimate, but adjustment for sleep maintenance attenuated the sample prevalence ratio to 4.55 (95% CI: 1.91, 11.14). Sleep maintenance mediated 11.4% of the difference in hypertension prevalence between Blacks and Whites in this sample. CONCLUSIONS: Sleep maintenance mediated a small but significant portion of the disparity in hypertension between Blacks and Whites. Future research should investigate the mechanisms underlying these findings. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Energy Metabolism Occupational Health Race Factors Safety Sleep Sleep Initiation And Maintenance Disorders
• Keywords:
  Author Keywords: Blood Pressure Blood Pressure Cardiovascular Disease Hormone Activity Hypertension Mediation Metabolic Effects Racial Disparities Racial Factors Sleep Deprivation Sleep Disorders Sleep Maintenance Sociological Factors

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• ISSN:
  0895-7061
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Illinois ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  29
• Issue:
  12
• NIOSHTIC Number:
  nn:20052700
• Citation:
  Am J Hypertens 2016 Dec; 29(12):1353-1357
• Contact Point Address:
  Laura J. Rasmussen-Torvik Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
• Email:
  ljrtorvik@northwestern.edu
• Federal Fiscal Year:
  2017
• Performing Organization:
  University of Chicago
• Peer Reviewed:
  True
• Start Date:
  20090901
• Source Full Name:
  American Journal of Hypertension
• End Date:
  20150831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7d3f25172bc1dcdd8c7266e5710387a68cb15a98e053411e15fcb27f8a4be97f7664297e56c088d58399ebcf9c6e8a2632fdb710173ce80daf80ae0afecdf8c6
• Download URL:
  https://stacks.cdc.gov/view/cdc/212195/cdc_212195_DS1.pdf
• File Type:
  [PDF - 131.30 KB ]