A Meta-analysis Of Prospective Studies On The Relationship Between Sleep Duration And Incidence Risk Of Hypertension

Objectives:Explore the relationship between sleep duration and incidence risk of hypertension by Meta-analysis,and provide the basis for primary prevention and treatment of hypertension.Methods:Retrieve multiple electronic databases by computer,including EMBASE,PubMed,Cochrane,CNKI,VIP and Wanfang database,a comprehensive search of prospective cohort studies published before February 2017 on the relationship between hypertension and the sleep duration.At the same time,two researchers searched the references of the selected documents.After formulating strict inclusion and exclusion criteria,the researchers screen and extract the data,make NOS quality evaluation of selected literature,and carry on the included literature meta-analysis with Stata12.0.The relative risk(RR)and its 95% confidence interval(CI)were used to evaluate the relationship between the short and long sleep duration and incidence risk of hypertension.And make the test for heterogeneity,according to the P value of the Q statistics and the I2 statistics to select combining model,if there is no significant heterogeneity between the studies,we will apply a fixed effects model,otherwise random effects model.When the heterogeneity exists,the source of heterogeneity in subgroup analysis is performed.Publication bias was achieved by observing funnel plot symmetry and Begg’s test and Egger’s test.Sensitivity analysis was used to evaluate the stability of the results.Results:2345 articles were retrieved from 6 electronic databases,together with 3 articles retrieved by hand,with a total of 2348 articles.By reading the title,the abstract,the full text,2336 articles were excluded,finally,A total of 12 articles met the inclusion criteria,of which 1 were included in 3 different cohort studies.Therefore,a total of 14 prospective cohort studies were included in the meta-analysis,including 44611 cases of hypertension and 22927 participants.Overall,the incidence risk of hypertension with short sleep duration and long sleep duration were 1.12(95%CI(1.05,1.19))、0.98(95%CI(0.94,1.03)).The corresponding P value of Heterogeneity analysis were 0.079(I2=38.2%)and 0.672(I2=0.00%).Funnel plot and Begg’s and Egger’s test results showed that there was no publication bias,and the corresponding P values of the Begg’s test were 0.951 and 0.30 respectively,the corresponding P values of the Egger’s test were 0.598 and 0.479 respectively.Subgroup analysis showed that short sleep duration increases the incidence risk of hypertension in women(RR=1.19,95%CI:1.07-1.33)and adults younger than 60 years old(RR=1.18,95%CI:1.06-1.32).These results of meta-analysis were of better stability by sensitivity analysis.Conclusion:Short sleep duration increases the incidence risk of hypertension,but long sleep duration is not associated with risk of hypertension.