The association between PSQI score and hypertension in a Chinese rural population: the Henan Rural Cohort Study

Abstract

Objectives: This study investigated the association between poor sleep quality and hypertension, and evaluated how the Pittsburgh Sleep Quality Index (PSQI) score correlates with blood pressure and prevalent hypertension.

Methods: A total of 27, 912 participants aged 18-79 years from the Henan Rural Cohort Study were included into the current study. PSQI score was classified as <3, 3-, 6-, ≥9. Multivariate logistic regression models and restricted cubic spline with hypertension as a dependent variable were conducted. A meta-analysis was conducted to validate the result of the cross-sectional study.

Results: Altogether, 6,085 (21.80%) were poor sleepers and 9,056 (32.44%) suffered from hypertension. The odds ratios (ORs) (95% confidence intervals (CIs)) of participants with sleep quality of 3-, 6-, ≥9 were 1.16(1.07-1.26), 1.35(1.21-1.50) and 1.62 (1.39-1.88) compared to the participants with a score of less than 3 among participants excluding undiagnosed hypertension. ORs and 95% CIs per 3 increment score were higher for hypertension (1.16, 1.11-1.21) among total population, (1.18, 1.10-1.27) among men and (1.13, 1.08-1.19) among women. Compared to reference, poor sleep quality was associated with a higher odd of hypertension (OR 1.09, 95% CI 1.01-1.17) for total population, (1.14, 1.00-1.30) for men and (1.04, 0.95-1.13) for women. Moreover, the odds of hypertension were increased with increment of PSQI score after fitting restricted cubic splines (P_trend <0.01). The meta-analysis showed that pooled OR of hypertension was significantly higher for poor sleepers (1.62, 1.03-2.56, I² = 97.3%, P < 0.001).

Conclusions: Higher PSQI score was associated with increased odds of prevalent hypertension in both genders. In addition, poorer sleepers might suffer from hypertension.

Keywords: Hypertension; Meta-analysis; PSQI; Rural population; Sleep quality.