Insomnia and the risk of hypertension: A meta-analysis of prospective cohort studies

Liqing Li; Yong Gan; Xiaogang Zhou; Heng Jiang; Yulan Zhao; Qingfeng Tian; Yan He; Qiao Liu; Qian Mei; Chunmei Wu; Zuxun Lu

doi:10.1016/j.smrv.2020.101403

Insomnia and the risk of hypertension: A meta-analysis of prospective cohort studies

Sleep Med Rev. 2021 Apr:56:101403. doi: 10.1016/j.smrv.2020.101403. Epub 2020 Nov 28.

Authors

Liqing Li¹, Yong Gan², Xiaogang Zhou³, Heng Jiang⁴, Yulan Zhao⁵, Qingfeng Tian⁶, Yan He⁶, Qiao Liu⁵, Qian Mei⁵, Chunmei Wu⁷, Zuxun Lu⁸

Affiliations

¹ School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China; School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
² School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
³ School of Economics and Management, East China Jiaotong University, Nanchang, Jiangxi, China.
⁴ Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
⁵ School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China.
⁶ School of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
⁷ School of Basic Medicine, Gannan Medical University, Ganzhou, Jiangxi, China. Electronic address: wuchunmei08@gmail.com.
⁸ School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. Electronic address: zuxunlu@yahoo.com.

PMID: 33360604
DOI: 10.1016/j.smrv.2020.101403

Abstract

The relationship between insomnia and hypertension remains inconclusive. Thus, we conducted a meta-analysis of prospective cohort studies to evaluate the association between insomnia and the risk of hypertension. Relevant prospective cohort studies were searched from PubMed, Embase, and Web of Science from their inception to October 2019. A random-effects model was used to calculate the pooled relative risk (RR) with 95% confidence interval (CI). A total of fourteen prospective cohort studies involving 395,641 participants were included in this study. The pooled RR of insomnia on hypertension was 1.21 (95%CI: 1.10-1.33). An increased risk of hypertension was observed in participants with difficulty maintaining sleep (RR = 1.27; 95%CI: 1.04-1.55) and early morning awakening (RR = 1.14; 95%CI: 1.08-1.20), but was not statistically significant in participants with difficulty falling asleep (RR = 1.14; 95%CI: 0.95-1.37). In addition, the results were statistically significant in the European population (RR = 1.08, 95%CI: 1.02-1.14), but not significant in Asian and American populations (RR = 1.54, 95%CI: 0.98-2.40; RR = 1.21, 95%CI: 0.89-1.65). The study findings indicate that insomnia is associated with a significantly increased risk of hypertension. This may have substantial implications for the prevention of hypertension in individuals with insomnia symptoms.

Keywords: Cohort; Hypertension; Insomnia; Meta-analysis; Sleep disorder.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review

MeSH terms

Asian People
Humans
Hypertension* / epidemiology
Prospective Studies
Risk
Risk Factors
Sleep Initiation and Maintenance Disorders* / complications
Sleep Initiation and Maintenance Disorders* / epidemiology