Hypertension risk in population with sleep disturbance in Russia/Siberia (WHO program “MONICA-psychosocial”): Focus on gender differences

Objective. To determine the gender differences regarding the impact of sleep disturbances on the risk of arterial hypertension (HTN) in the open population aged 25–64 years in Russia/Siberia.

Design and methods. As part of the screening program III WHO “MONICA-psychosocial”, we surveyed a random representative sample of the population of both sexes aged 25–64 years in Novosibirsk in 1994 (men: n = 657, mean age — 44,3 ± 0,4 years, the response — 82,1%; women: n = 689, mean age — 45,4 ± 0,4 years, the response — 72,5%). The screening survey program included registration of social and demographic data, the assessment of sleep disorders (Jenkins test). During 16‑year follow-up we identified 229 cases of new-onset HTN in women and 46 cases in men. The “chi-squared” (χ 2 ) Pearson criterion was used to assess the differences between groups. To assess the risk (HR — hazard ratio) we used univariate and multivariate regression model of Cox proportional hazards (Cox-regression). The reliability in all kinds of analysis was adopted at the level of significance p ≤ 0,05.

Results. In an open population (aged 25–64 years), 48.6% men and 65.9% women had sleep disturbances. The following characteristic features were identified: marital status does not differ, but widowhood was associated with greater risk of HTN greater in men (HR = 14.6) than in women (HR = 5.6). Low level of education was stronger associated with sleep disordersin women (83.3%) than in men (53.7%). Women of following professions reported sleep disorders more often than men: middle managers (78.3% and 48.9%, respectively) and technical workers (63.2% and 42.1%, respectively). The risk of developing HTN at 5-, 10‑and 16‑year follow-up was higher in men (HR = 5.4, 2.68 and 1.2) with sleep disorders than in women (HR = 4.35, 2.3 and 1.05).

Conclusions. Our analysis showed that in Russian population sleep disorders are more common in women than in men. However, in 5–16 years men with sleep disorders have higher risk of developing HTN than women.

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