Sleep Enhancement to Decrease Blood Pressure: A Randomized, Controlled Trial

增强睡眠以降低血压：一项随机对照试验

• 批准号: 10210282
• 负责人: Virend K Somers
• 金额: $ 77.27万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-20 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10210282
• 关键词: Adipose tissue; Adult; Affect; Aftercare; Aldosterone; Angiotensin II; Angiotensins; Antihypertensive Agents; Baroreflex; Behavior Therapy; Behavioral; Blood Pressure; Blood Vessels; Cardiovascular Diseases; Cardiovascular system; Cerebrovascular Disorders; Chronic; Complement; Complex; Corticotropin; Data; Development; Education; Educational Intervention; Elements; Endothelium; Equilibrium; Etiology; Health; Health Benefit; Health Hazards; Health Promotion; Health Status; Health education; Healthcare; Hormonal; Hour; Hydrocortisone; Hypertension; Insulin; Intervention; Life Style; Link; Longitudinal Studies; Maintenance; Measures; Mediator of activation protein; Metabolic; Metabolism; Modernization; Molecular; Neurosecretory Systems; Partner in relationship; Physiological; Placebos; Play; Population; Prevalence; Probability; Public Health; Randomized; Randomized Controlled Trials; Regulation; Renin; Renin-Angiotensin-Aldosterone System; Reporting; Research Design; Research Personnel; Risk; Sleep; Sleep Deprivation; Societies; Testing; Vasoconstrictor Agents; Vasodilator Agents; Visceral fat; arm; attentional control; blood glucose regulation; blood pressure reduction; blood pressure regulation; cardiovascular health; cardiovascular risk factor; care burden; cost; diabetes risk; efficacy study; experience; follow-up; group intervention; hormone regulation; improved; insight; molecular phenotype; mortality risk; psychologic; randomized controlled study; relating to nervous system; response; risk stratification

Project Summary/Abstract Hypertension is the major risk factor for cardiovascular and cerebrovascular diseases worldwide. The escalating prevalence of inadequate sleep now parallels that of hypertension. Observational and experimental evidence favoring a causal relation between insufficient sleep and hypertension are particularly compelling - sleeping 6 hours or less per night is associated with a 20-32% higher probability of incident hypertension. Since sleep curtailment is largely voluntary, sleep deficiency may be corrected and the detrimental health consequences potentially reversed. Nevertheless, systematic studies and robust evidence of health-promoting effects of sleep enhancement are lacking, and there are no data regarding the underlying mechanisms that may be involved, especially with regard to blood pressure (BP) control. We seek to overcome these limitations by conducting a randomized controlled study to investigate the effects of 8 weeks of sleep enhancement/extension in prehypertensive and stage 1 hypertensive subjects who report habitual short sleep (<6.5 hours/night). Antihypertensive effects of sleep enhancement achieved through education and behavioral intervention will be compared to a placebo/attention control condition receiving health education. Comprehensive measures, including cardiovascular, metabolic and neuroendocrine markers, complemented by molecular phenotyping and psychological characterization, will generate insights into the mechanisms and mediators linking enhanced sleep to any BP reduction, and to any overall improved cardiovascular risk profile. We propose the following Specific Aims comparing sleep enhancement/extension to placebo/attention control: Aim 1. To determine the impact of sleep enhancement on 24-hour BP. Aim 2. To evaluate effects of sleep enhancement on neural circulatory control and vascular function. Aim 3. To assess changes in systemic and local renin-angiotensin-aldosterone system (RAAS) regulation in response to sleep enhancement. Aim 4. To identify metabolic and neuroendocrine mediators of the effects of sleep enhancement on BP. This proposal builds upon important strengths, including an interdisciplinary team of investigators with unique experience and expertise in each of the domains investigated, exciting preliminary data, and the minimization of potential confounders. The integration of physiological and molecular variables in a translational framework, complemented by psychological and behavioral characterization, will further bolster the proposed study. Data from these studies will be pivotal in the development and implementation of effective, low cost, health promoting sleep extension strategies applicable both on a targeted and a population-wide basis.

项目概要/摘要 高血压是全世界心脑血管疾病的主要危险因素。这 睡眠不足的患病率现在与高血压的患病率同步上升。支持睡眠不足与高血压之间存在因果关系的观察和实验证据尤其令人信服——每晚睡眠 6 小时或更少与发生高血压的概率增加 20-32% 相关。由于睡眠减少在很大程度上是自愿的，因此睡眠不足可以得到纠正，并且有可能扭转对健康的不利影响。然而，缺乏关于增强睡眠促进健康作用的系统研究和强有力的证据，并且没有关于可能涉及的潜在机制的数据，特别是在血压（BP）控制方面。我们试图通过开展一项随机对照研究来克服这些局限性，以调查 8 周的睡眠增强/延长对习惯性短睡眠（<6.5 小时/晚）的高血压前期和 1 期高血压受试者的影响。通过教育和行为干预实现的睡眠增强的抗高血压效果将与接受健康教育的安慰剂/注意力控制条件进行比较。综合措施，包括心血管、代谢和神经内分泌标记物，辅以分子表型和心理表征，将深入了解改善睡眠与血压降低以及总体改善心血管风险状况之间的机制和介质。我们提出以下具体目标，将睡眠增强/延长与安慰剂/注意力控制进行比较： 目标 1. 确定睡眠增强对 24 小时血压的影响。目标 2. 评估睡眠增强对神经循环控制和血管功能的影响。目标 3. 评估睡眠增强时全身和局部肾素-血管紧张素-醛固酮系统 (RAAS) 调节的变化。 目标 4. 确定睡眠增强对血压影响的代谢和神经内分泌介质。 该提案建立在重要的优势之上，包括在每个调查领域拥有独特经验和专业知识的跨学科研究人员团队、令人兴奋的初步数据以及最大程度地减少潜在混杂因素。将生理和分子变量整合到翻译框架中，并辅以心理和行为表征，将进一步支持拟议的研究。这些研究的数据对于制定和实施有效、低成本、促进健康的睡眠延长策略至关重要，该策略既适用于有针对性的人群，也适用于整个人群。

项目成果

Apneic Sleep, Insufficient Sleep, and Hypertension.

睡眠呼吸暂停、睡眠不足和高血压。

• 发表时间: 2019
• 作者: Mansukhani, Meghna P;Covassin, Naima;Somers, Virend K
• 通讯作者: Somers, Virend K

Experimental Weight Gain Increases Ambulatory Blood Pressure in Healthy Subjects: Implications of Visceral Fat Accumulation.

实验性体重增加会增加健康受试者的动态血压：内脏脂肪积累的影响。

• 发表时间: 2018
• 影响因子: 8.9
• 作者: Covassin, Naima;Sert;Singh, Prachi;Romero;Davison, Diane E;Lopez;Jensen, Michael D;Somers, Virend K
• 通讯作者: Somers, Virend K

Trends in Use of Melatonin Supplements Among US Adults, 1999-2018.

1999-2018 年美国成年人褪黑激素补充剂的使用趋势。

• 发表时间: 2022-02-01
• 作者: Li, Jingen;Somers, Virend K;Xu, Hao;Lopez;Covassin, Naima
• 通讯作者: Covassin, Naima

Objective but Not Subjective Short Sleep Duration Is Associated With Hypertension in Obstructive Sleep Apnea.

客观而非主观的睡眠时间短与阻塞性睡眠呼吸暂停的高血压有关。

• 发表时间: 2018
• 作者: Ren, Rong;Covassin, Naima;Yang, Linghui;Li, Yun;Zhang, Ye;Zhou, Junying;Tan, Lu;Li, Taomei;Li, Xiao;Wang, Yanyan;Zhang, Jihui;Wing, Yun;Li, Weimin;Somers, Virend K;Tang, Xiangdong
• 通讯作者: Tang, Xiangdong

From Resistant Airway to Resistant Hypertension.

从抵抗气道到抵抗性高血压。

• 发表时间: 2019
• 影响因子: 37.8
• 作者: Covassin, Naima;Somers, Virend K
• 通讯作者: Somers, Virend K