Frontiers in Cardiovascular Medicine (Sep 2023)

Examining the U-shaped relationship of sleep duration and systolic blood pressure with risk of cardiovascular events using a novel recursive gradient scanning model

  • Shuo Yang,
  • Nanxiang Zhang,
  • Zichao Liang,
  • Yuduan Han,
  • Hao Luo,
  • Yingfeng Ge,
  • Jianan Yin,
  • Chonglong Ding,
  • Chao Li,
  • Qitong Zhang,
  • Jinxin Zhang

DOI
https://doi.org/10.3389/fcvm.2023.1210171
Journal volume & issue
Vol. 10

Abstract

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BackgroundObservational studies have suggested U-shaped relationships between sleep duration and systolic blood pressure (SBP) with risks of many cardiovascular diseases (CVDs), but the cut-points that separate high-risk and low-risk groups have not been confirmed. We aimed to examine the U-shaped relationships between sleep duration, SBP, and risks of CVDs and confirm the optimal cut-points for sleep duration and SBP.MethodsA retrospective analysis was conducted on NHANES 2007–2016 data, which included a nationally representative sample of participants. The maximum equal-odds ratio (OR) method was implemented to obtain optimal cut-points for each continuous independent variable. Then, a novel “recursive gradient scanning method” was introduced for discretizing multiple non-monotonic U-shaped independent variables. Finally, a multivariable logistic regression model was constructed to predict critical risk factors associated with CVDs after adjusting for potential confounders.ResultsA total of 26,691 participants (48.66% were male) were eligible for the current study with an average age of 49.43 ± 17.69 years. After adjusting for covariates, compared with an intermediate range of sleep duration (6.5–8.0 h per day) and SBP (95–120 mmHg), upper or lower values were associated with a higher risk of CVDs [adjusted OR (95% confidence interval) was 1.20 (1.04–1.40) for sleep duration and 1.17 (1.01–1.36) for SBP].ConclusionsThis study indicates U-shaped relationships between SBP, sleep duration, and risks of CVDs. Both short and long duration of sleep/higher and lower BP are predictors of cardiovascular outcomes. Estimated total sleep duration of 6.5–8.0 h per day/SBP of 95–120 mmHg is associated with lower risk of CVDs.

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