Data_Sheet_1_Healthy Sleep Associated With Lower Risk of Hypertension Regardless of Genetic Risk: A Population-Based Cohort Study.pdf

Background: Hypertension is a leading contributor to the global burden of disease and to mortality. The combined effects of sleep factors on the risk of hypertension are unclear. We aimed to evaluate the effect of combined sleep factors on the risk of hypertension and to explore whether this association is independent of genetic risk.
Methods: This population-based prospective cohort study included 170,378 participants from the UK Biobank study. We conducted a healthy sleep score based on a combination of major five sleep factors and a genetic risk score based on 118 risk variants. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
Results: A total of 170,378 participants were included. Compared to participants with a healthy sleep score of 0–1, those with healthy sleep scores of 2 (HR, 0.90; 95% CI, 0.83–0.98), 3 (HR, 0.81; 95% CI, 0.75–0.88), 4 (HR, 0.74; 95% CI, 0.68–0.81), or 5 (HR, 0.67; 95% CI, 0.59–0.77) had increasingly lower risks of hypertension (P for trend <0.001). Participants with high genetic risk and an unfavorable sleep pattern had a 1.80-fold greater risk of hypertension than participants with low genetic risk and a favorable sleep pattern. The association between sleep patterns and hypertension persisted in subgroup analysis, stratified by the genetic risk. Nearly 18.2% of hypertension events in this cohort could be attributed to unfavorable sleep pattern.
Conclusions: Favorable sleep pattern was associated with a low risk of hypertension, regardless of genetic risk. These findings highlight the potential of sleep interventions to reduce risk of hypertension across entire populations.

研究背景：高血压是全球疾病负担与死亡的首要诱因。目前睡眠多因素联合作用对高血压发病风险的影响尚不明确。本研究旨在评估睡眠多因素联合对高血压发病风险的影响，并探讨该关联是否独立于遗传风险。
研究方法：本项基于人群的前瞻性队列研究纳入了来自英国生物银行（UK Biobank）的170378名参与者。我们基于五大核心睡眠因素构建了健康睡眠评分，并基于118个风险变异构建了遗传风险评分。采用Cox比例风险回归模型估算风险比（HR）与95%置信区间（CI）。
研究结果：本研究共纳入170378名参与者。与健康睡眠评分为0~1分的参与者相比，健康睡眠评分分别为2分（HR=0.90，95%CI：0.83~0.98）、3分（HR=0.81，95%CI：0.75~0.88）、4分（HR=0.74，95%CI：0.68~0.81）或5分（HR=0.67，95%CI：0.59~0.77）的参与者高血压发病风险呈逐步降低趋势（趋势检验P<0.001）。与低遗传风险且睡眠模式健康的参与者相比，高遗传风险且睡眠模式不良的参与者高血压发病风险为其1.80倍。按遗传风险分层的亚组分析显示，睡眠模式与高血压的关联仍具有统计学意义。本队列中近18.2%的高血压事件可归因于不良睡眠模式。
研究结论：无论遗传风险如何，健康的睡眠模式均与较低的高血压发病风险相关。本研究结果凸显了睡眠干预在全人群中降低高血压发病风险的潜在价值。