Poor sleep is responsible for the impaired nocturnal blood pressure dipping in elderly hypertensive: A cross-sectional study of elderly.

Objective: This study was aimed to assess whether sleep disorder was associated with an increased risk of less nocturnal blood pressure (BP) dipping in elderly patients with hypertension.

Methods: Cases were 1006 patients, aged >60 years, who were admitted to hospital with diagnosed hypertension during 2016-2017, and were divided into three groups with the systolic nocturnal BP dipping of 10%, and 0% as the cut-off value. The patients' sleep was evaluated by Pittsburgh sleep quality index (PSQI).

Results: Compared to non-dipper BP rhythm patients (n = 382) and dipper BP rhythm patients (n = 132), reverse dipper patients (n = 492) exhibited higher PSQI score and had higher scores on six components with the exception of use sleep drug (p < 0.05). Multivariate logistic regression indicated that poor sleep, which was defined as high score of PSQI or its seven components, was associated with prevalence of reverse dipper in elderly hypertensive (odds ratio (OR) = 1.17, (95% confidence interval (CI), 1.13-1.21, p < 0.05) after adjusting for risk factors of hypertension. Multiple linear regression analysis showed that there was a significant negative correlation between PSQI score (include its seven components) and nocturnal BP dipping value after adjusting for risk factors of hypertension (β = -0.584, p < 0.001).

Conclusions: In elderly patients with hypertension, poor sleep quality individuals were more prone to reverse dipper BP rhythm. Even adjusting for the effect of known risk factors of hypertension, poor sleep may contribute to attenuated BP dipping in elderly hypertensive.