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Variability in home-measured blood pressure and heart rate: associations with self-reported insomnia and sleep duration

Johansson, Jouni K.; Kronholm, Erkki; Jula, Antti M.

doi: 10.1097/HJH.0b013e32834abccd
Original papers: Blood pressure measurement
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Objective Both self-reported sleep disorders and higher variability in home blood pressure (BP) and home heart rate (HR) have been associated with increased cardiovascular mortality. The objective of our study was to assess the associations of the variability in home-measured BP and HR with self-reported insomnia and sleep duration.

Methods We studied a representative sample of Finnish adult population with 1908 study participants aged 41–74 years. BP/HR measurements were performed on 7 consecutive days. The variability in home-measured BP/HR was defined as the standard deviation of morning − evening, day-by-day and first − second measurements. Self-reported insomnia and sleep duration questionnaires were used to classify participants with sleep disorders.

Results Results from Finn-home study show that morning − evening, day-by-day (morning and evening) and first − second home BP variability variables were significantly higher in participants with persistent insomnia than in those without insomnia. Morning − evening, day-by-day, morning day-by-day and first − second measurements of home HR variability variables were significantly higher in participants with persistent insomnia than in those without insomnia. Systolic morning − evening, day-by-day and morning day-by-day variables of home BP variability were significantly higher in long sleepers and systolic morning day-by-day, diastolic day-by-day and diastolic first − second measurement of home BP variability variables were higher in short sleepers than in the reference group. Insomnia combined with short sleep duration further increases home BP/HR variability.

Conclusion As self-reported sleep disorders are associated with greater variability in home BP/HR and both have cardiovascular prognostic value, we encourage physicians to evaluate these easily obtainable measurements in clinical practice to help identify patients at risk.

Population Studies Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland

Correspondence to Jouni K. Johansson, MD, Population Studies Unit, National Institute for Health and Welfare, Peltolantie 3, FIN-20720 Turku, Finland Tel: +358 503586060; fax: +358 2 3316720; e-mail: jouni.johansson@utu.fi

Abbreviations: ATC, anatomical therapeutic chemical; BP, blood pressure; CIDI, composite international diagnostic interview; HR, heart rate; MI, myocardial infarction; SD, standard deviation

Received 14 December, 2010

Revised 13 May, 2011

Accepted 8 July, 2011

© 2011 Lippincott Williams & Wilkins, Inc.