Objective : To investigate the relationship between sleep quality and the risk of resistant hypertension(RH),and to explore the effects of sleep quality on the development of hypertension in patients with resistant hypertension.Methods: 425 patients were admitted from May 2019 to February 2020 in terms of the diagnostic criteria for hypertension.Resistant hypertension was defined according to guidelines from 2018 china,320 patients were assigned non-resistant hypertension group(NRH)and 105 patients were assigned resistant hypertension(RH).Sleep quality was defined by the Pittsburgh sleep quality index questionnaire(PSQI).The differences in sleep quality and other sleep characteristics between the two groups were compared.After that,the patients with RH were divided into normal sleep quality group(NSQG)and abnormal sleep quality group(ASQG),and the biochemical index,ambulatory blood pressure and cardiac ultrasound results were compared between NSQG and ASQG groups.Results:(1)Resistant hypertension compared with non-resistant hypertension:(1)The prevalence of chronic kidney disease and BMI was significantly increased(P <0.05);(2)The quality of sleep and subjective sleep were significantly worsened,and the duration of sleep decreased.Time to fall asleep was prolonged,and sleep efficiency was reduced(P <0.05).(3)Set PSQI≤7 as the reference group,group of PSQI > 7 can increase the risk of resistant hypertension(OR = 1.76,adjusted OR = 1.82,P <0.05).After stratified by gender,women can still increase the risk of refractory hypertension(OR = 2.19,adjusted OR = 2.19,P <0.05),which was not found by men.After stratified by age,age <60 years increased the risk of resistant hypertension(OR = 3.0,adjusted OR = 3.81,P <0.05),but no correlation was found between age ≥60 years.(4)Set the sleep time of 6-7 hours as the reference group.When the confounding factors are not adjusted,the sleep time <6 hours can increase the risk of refractory hypertension(OR= 1.76,P <0.05).After adjusting for confounding factors,no correlation was found;after stratified by gender,whether or not confounding factors are adjusted,men’s sleep time <6 hours can increase the risk of resistant hypertension(OR = 2.13,adjusted OR= 1.93,P <0.05).No correlation was seen in women.After stratified by age,before adjusting for confounding factors,the sleep time of persons <60 years old <6 hours can increase the risk of resistant hypertension(OR = 2.95,P <0.05).After adjusting for confounding factors,it was not found Related to it.No correlation was found between age ≥60 years.(5)Whether confounding factors were adjusted and stratified by gender and age or not,no correlation was found between sleep time greater than 7 hours and the risk of resistant hypertension.(2)Compared with the normal sleep quality: all-day,day,and night MSBP,all-day,day,and night systolic blood pressure load,night-time diastolic blood pressure load,LVMI and the proportions of non-dipper blood pressure were all increased(P <0.05).(3)Relevant factors affecting LVMI: MSBP and MDBP throughout the day,day and night,all day,day and night systolic and diastolic blood pressure,morning blood pressure surge,PSQI scores are positively correlated,multiple stepwise regression results: Systolic and diastolic blood pressure during the day,day,and night,MDBP at night,and morning blood pressure surge are the main influencing factors of LVMI.Conclusion:(1)Poor sleep quality in women and younger than 60 years of age increases the risk of resistant hypertension,and men who sleep less than 6 hours increase the risk of resistant hypertension.(2)In patients with resistant hypertension,blood pressure levels and blood pressure load increase,blood pressure circadian rhythm disorders,and LVMI increase.(3)Systolic and diastolic blood pressure during the day,day,and night,MDBP at night,and morning blood pressure surge are the main influencing factors of LVMI. |