Moderate-to-vigorous Physical Activity And Sleep Duration Associate With Greater Odds Of Hypertension: Nhanes 2005-2006

Purpose: Moderate-to-vigorous physical activity (MVPA) and sleep behaviors have been independently associated with increased risk for hypertension (HTN), the leading risk factor for stroke and heart disease. However, these behaviors may be synergistic in contributing to HTN. The purpose of this study was to examine the odds of hypertension diagnosis (HTN) dependent on MVPA and sleep duration in a nationally-representative sample of U.S. men and women.

Methods: Adults (43.2±0.66 yrs) from National Health and Nutrition Examination Survey (2005-2006 cycle) data were analyzed for HTN odds using logistic regression. Daily accelerometer-measured MVPA (≥1952 ct, min∙day-1) and sleep duration (≤5, 6, 7, 8, or ≥9 hrs∙night-1) were predictors of HTN odds (referent category = 7 hrs∙night-1). Models controlling for the complex sampling design and possible confounders were first conducted on the entire sample of eligible participants followed by gender-stratified models.

Results: Of the total sample (n=1798), 487 (27.1% of sample) had HTN diagnosis. Most of the population slept 6-8 hrs∙night-1 (n=1477, 82.1%) with most sleeping 7 hrs∙night-1 (n=560, 31.1%). Adults averaged 28±0.78 min∙day-1 of MVPA. In the whole sample, MVPA was independently associated with lower odds of HTN (OR=0.77, 95% CI=0.65-0.91), while sleep duration revealed a U-shaped relationship with increased odds of HTN for short and long sleepers ( 7 hrs), especially in very short sleepers (≤ 5 hrs∙night-1, OR=1.65, 95% CI=1.02-2.68). Gender-stratified analyses agreed with whole-sample results for the association between MVPA and HTN (OR=0.77 both men and women). The U-shaped sleep duration-HTN relationship remained for men (≥ 9 hrs∙night-1, OR=2.98, 95% CI=1.58-5.64), but not for women. Only in women did sleep duration moderate the MVPA-HTN relationship (OR=1.17, 95% CI=1.01-1.35), such that increasing MVPA increased odds of HTN only in ≥ 9 hrs∙night-1 sleepers.

Conclusions: Greater MVPA was associated with lower odds of HTN in men and women. In men, both short and long sleep duration was associated with greater odds of HTN. In women, hypertension may be more related to the synergy between MVPA and sleep duration behaviors rather than their independent associations.