睡眠时间与高血压关系的荟萃分析

Meta-analysis of the association of sleep duration with hypertension

目的通过荟萃分析研究睡眠时间长短与高血压发生风险的相关性，为高血压的一级预防提供依据。方法计算机检索PubMed、Cochrane数据库、中国期刊全文数据库、维普中文期刊数据库及万方数据库，检索年限均为建库至2012-02，辅以其他检索方式，收集探索睡眠时间与高血压之间相关性的横断面观察性研究。由两名研究者按Cochrane系统评价方法，进行筛选、评价质量及提取资料，并用Stata11.0软件进行荟萃分析、发表偏倚分析及敏感性分析等统计分析。结果共纳入成人相关研究24篇，总计264 978人，荟萃分析结果显示睡眠时间过短与患高血压的风险增加有关，睡眠时间≤5 h或≤6 h均与患高血压风险增高有关（≤5 h：OR 1.19，95% CI 1.04-1.36；≤6 h：OR 1.28，95% CI 1.11-1.47，均P〈0.05），而并未发现睡眠时间≤7 h与患高血压风险增加有关（OR 1.12，95% CI 0.88-1.42）。睡眠时间过长也与患高血压风险增加有关（≥9 h：OR 1.13，95% CI 1.04-1.23，P〈0.05）。异质性分析结果提示文献来源的地区分布是异质性来源之一。Begg＇s检验和Egger＇s检验表明无发表偏倚。敏感性分析示本次荟萃分析结果稳定性较好。结论成人睡眠时间与高血压在观察性研究层面上存在U形曲线关系。

Objective To investigate the association of sleep duration with hypertension by recta-analysis, aiming to justify primary prevention of hypertension. Methods From PuhMed, Cochrane Library, CNKI, VIP and Wanfang databases since their establishment until February 2012, a cross sectional search for the link between sleep duration and hypertension was performed and supplemented by other retrieval methods. Then the related data were select ed, evaluated, and extracted by two investigators independently according to Cochrane system. Publication bias was evaluated, and sensitivity and meta-analyses were conducted with Statall. 0. Results A total of 24 studies were collected where 264 978 adults were included. The Meta-analysis showed that short sleep duration was associ ated with a higher risk of hypertension （sleep duration≤5 h： OR 1.19, 95% CI 1.04--1.36; ≤6 h： OR 1.28, 95% CI 1.11--1.47, both P〈0.05）, while long sleep duration also increased the risk of hypertension （sleep dura tion ≥9 h： OR 1.13; 95% CII 1.04--1.23, P〈0.05）. No evidence suggested any relation between higher risk of hypertension and the sleep duration 47 h （OR 1.12, 95% CI 0. 88--1.42）. Heterogeneity analysis indicated that the geographical location was one of the heterogeneity resources. No publication bias was found by Beggs and Egg- er＇s tests. These results of meta-analysis were of better stability by sensitivity analysis. Conclusion A U-shaped relationship between sleep duration and hypertension was found among adults through cross-sectionally observational study.