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Original Article

Sleep Duration and the Related Factors of Hypertension among Korean Middle-aged Adults

Eunok Park
Korean Journal of Adult Nursing 2014;26(3):372-381.
Published online: June 30, 2014

College of Nursing, Jeju National University, Jeju, Korea

Corresponding author: Park, Eunok College of Nursing, Jeju National University, 102 Jejudaehak-ro, Jeju 690-756, Korea. Tel: +82-64-754-3882, Fax: +82-64-702-2686, E-mail: eopark@jejunu.ac.kr
• Received: March 30, 2014   • Accepted: June 5, 2014

Copyright © 2014 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    This study investigated the prevalence of hypertension, explored sleep duration, and examined the related factors to hypertension in Korean middle-aged adults.
  • Methods
    Using raw data from the Korean National Health and Nutritional Examination Survey (KNHANES) conducted from 2008 to 2010, a secondary analysis was performed with data from 13,230 adults aged 30~64 years. x2-test and multiple logistic regressions was used for the data analysis.
  • Results
    The prevalence of hypertension among Korean middle-aged adults was 21.8% and 40.3% among participants reported that their average sleep duration was below six hours a night. Risk factors for hypertension include: female (the odds ratio (OR) 1.66 for male), 50~64 years age group (OR 3.66 for 30~49 years age group), education level of elementary school (OR 1.84 for university level), low household income (OR 1.27 for upper), obesity (OR 2.41), high risk drinking (OR 1.64), and sleep duration≤6 hrs (OR 1.16 for 8 hrs of sleep).
  • Conclusion
    High risk population of hypertension could be male, aged, low education, and low income. Obesity, high risk drinking, and short sleep duration should be considered as risk factors for hypertension. Interventions for obesity management, adequate alcohol drinking and sleep duration could be considered for preventing hypertension.
  • Key Words: Sleep; Hypertension; Adult; KNHANES
Table 1.
Prevalence of Hypertension by General Characteristics (N=13,230)
Variable Categories n† %‡ HT W % p
Gender Male 5,701 50.5 26.2 ＜.001
Female 7,529 49.5 17.4
Age (year) 30~49 8,047 66.2 13.2 ＜.001
50~64 5,183 33.8 38.7
Marital status Never married 711 6.8 16.3 ＜.001
Married 11,298 84.8 21.8
Divorced, separated 1,186 8.4 27.3
Education Elementary school 2,334 14.9 38.9 ＜.001
Middle school 1,751 12.8 29.4
High school 4,993 39.1 18.8
≥College 4,140 33.2 14.9
Household income Low 1,526 10.7 32.3 ＜.001
Moderate low 3,306 25.7 21.3
Moderate upper 4,075 31.6 20.5
Upper 4,137 32.0 20.0
Occupation Professional, manager 1,796 15.2 17.3 ＜.001
Clerk 1,186 9.7 17.2
Service & sales 2,066 16.4 20.8
Agricultural, physical worker 3,928 29.8 26.8
None 4,186 28.9 21.1
Medicaid No 12,869 97.6 21.7 .061
Recipients 339 2.4 26.5
Smoking No 8,641 59.9 20.1 ＜.001
Yes 4,575 40.1 24.4
Monthly drinking No 5,635 38.8 19.6 ＜.001
Yes 7,548 61.2 23.2
High risk drinking No 11,443 84.2 20.3 ＜.001
Yes 1,787 15.8 30.3
Physical activity; severe No 10,949 82.3 21.3 .003
Yes 2,266 17.7 24.5
Physical activity; moderate No 11,331 86.6 21.6 .270
Yes 1,886 13.4 22.9
Walking over 30min/day No 7,644 58.3 20.9 .011
Yes 5,560 41.7 23.1
BMI (kg/m2) ＜18.5 423 3.1 7.7 ＜.001
≥18.5~＜25.0 8,348 62.8 16.1
≥25.0 4,408 34.1 33.5
Perceived stress Little 9,386 70.7 22.2 ＜.001
Much 3,843 29.3 20.9
Sleep hours ≤6 hrs 5,238 40.3 24.2 ＜.001
7 hrs 4,087 30.7 20.4
8 hrs 3,056 22.7 19.8
≥9 hrs 849 6.3 21.6
Hypertension No 10,309 78.2    
Yes 2,921 21.8    

HT=hypertension; W=weighted; BMI=body mass index.

†The difference between N with total n is due to missing value;

‡Total percent is not sometimes equal to 100.0 exactly because of rounding off the numbers to two decimal places.

Table 2.
Sleep Duration of the Subjects by General Characteristics
Variables Categories Sleep duration (W %)† p
≤6 hrs 7 hrs 8 hrs ≥9 hrs
Total   40.3 30.7 22.7 6.3 ＜.001
Gender Male 42.1 30.6 21.6 5.7
Female 38.5 30.7 23.8 6.9
Age (year) 30~49 38.4 32.3 23.1 6.3 ＜.001
50~64 44.1 27.5 22.0 6.3
Marital status Never married 41.5 27.8 24.3 6.4 ＜.001
Married 39.4 31.6 22.8 6.3
Divorced, separated 49.2 24.3 20.5 6.0
Education Elementary school 47.1 24.9 18.4 9.6 ＜.001
Middle school 43.2 27.5 23.3 6.1
High school 38.0 31.2 24.2 6.7
≥College 39.1 33.9 22.6 4.4
Household income Low 42.7 26.6 23.0 7.7 ＜.001
Moderate low 40.5 29.4 23.1 7.0
Moderate upper 39.2 31.0 23.6 6.2
Upper 40.3 33.2 21.4 5.2
Occupation Professional, manager 43.3 33.8 19.6 3.2 ＜.001
Clerk 41.6 35.2 20.5 2.6
Service & sales 40.2 31.5 22.7 5.6
Agricultural, physical worker 42.6 28.4 22.6 6.4
Medicaid None 36.0 29.5 25.3 9.3 ＜.001
No 40.2 30.8 22.8 6.3
Recipients 48.2 26.8 17.3 7.8

W=weighted.

†Total percent is not sometimes equal to 100.0 exactly because of rounding off the numbers to two decimal places.

Table 3.
Logistic Regression for Hypertension
Variable (reference group)   Odds Lower Upper p
Gender (Female) Male 1.66 1.48 1.86 ＜.001
Age group (30~49year) 50~64 year 3.66 3.19 4.20 ＜.001
Education level (College) Elementary school 1.84 1.51 2.24 ＜.001
Middle school 1.42 1.17 1.71 ＜.001
High school 1.26 1.09 1.46 .002
Household income (upper) Low 1.27 1.04 1.55 .017
Moderate low 0.90 0.78 1.04 .156
Moderate upper 1.00 0.86 1.16 .995
High risk drinking (no) Yes 1.64 1.41 1.92 ＜.001
Obesity (normal) Underweight 0.59 0.38 0.92 .020
Overweight 2.41 2.15 2.71 ＜.001
Sleep duration (8 hours) ≤6 hours 1.16 1.02 1.33 .025
7 hours 1.07 0.93 1.23 .374
≥9 hours 1.04 0.81 1.34 .758
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    Citations to this article as recorded by  
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    Sleep Duration and the Related Factors of Hypertension among Korean Middle-aged Adults
    Korean J Adult Nurs. 2014;26(3):372-381.   Published online June 30, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.3.372
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    Sleep Duration and the Related Factors of Hypertension among Korean Middle-aged Adults
    Korean J Adult Nurs. 2014;26(3):372-381.   Published online June 30, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.3.372
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    Sleep Duration and the Related Factors of Hypertension among Korean Middle-aged Adults
    Sleep Duration and the Related Factors of Hypertension among Korean Middle-aged Adults

    Prevalence of Hypertension by General Characteristics (N=13,230)

    Variable Categories n† %‡ HT W % p
    Gender Male 5,701 50.5 26.2 ＜.001
    Female 7,529 49.5 17.4
    Age (year) 30~49 8,047 66.2 13.2 ＜.001
    50~64 5,183 33.8 38.7
    Marital status Never married 711 6.8 16.3 ＜.001
    Married 11,298 84.8 21.8
    Divorced, separated 1,186 8.4 27.3
    Education Elementary school 2,334 14.9 38.9 ＜.001
    Middle school 1,751 12.8 29.4
    High school 4,993 39.1 18.8
    ≥College 4,140 33.2 14.9
    Household income Low 1,526 10.7 32.3 ＜.001
    Moderate low 3,306 25.7 21.3
    Moderate upper 4,075 31.6 20.5
    Upper 4,137 32.0 20.0
    Occupation Professional, manager 1,796 15.2 17.3 ＜.001
    Clerk 1,186 9.7 17.2
    Service & sales 2,066 16.4 20.8
    Agricultural, physical worker 3,928 29.8 26.8
    None 4,186 28.9 21.1
    Medicaid No 12,869 97.6 21.7 .061
    Recipients 339 2.4 26.5
    Smoking No 8,641 59.9 20.1 ＜.001
    Yes 4,575 40.1 24.4
    Monthly drinking No 5,635 38.8 19.6 ＜.001
    Yes 7,548 61.2 23.2
    High risk drinking No 11,443 84.2 20.3 ＜.001
    Yes 1,787 15.8 30.3
    Physical activity; severe No 10,949 82.3 21.3 .003
    Yes 2,266 17.7 24.5
    Physical activity; moderate No 11,331 86.6 21.6 .270
    Yes 1,886 13.4 22.9
    Walking over 30min/day No 7,644 58.3 20.9 .011
    Yes 5,560 41.7 23.1
    BMI (kg/m2) ＜18.5 423 3.1 7.7 ＜.001
    ≥18.5~＜25.0 8,348 62.8 16.1
    ≥25.0 4,408 34.1 33.5
    Perceived stress Little 9,386 70.7 22.2 ＜.001
    Much 3,843 29.3 20.9
    Sleep hours ≤6 hrs 5,238 40.3 24.2 ＜.001
    7 hrs 4,087 30.7 20.4
    8 hrs 3,056 22.7 19.8
    ≥9 hrs 849 6.3 21.6
    Hypertension No 10,309 78.2    
    Yes 2,921 21.8    

    HT=hypertension; W=weighted; BMI=body mass index.

    †The difference between N with total n is due to missing value;

    ‡Total percent is not sometimes equal to 100.0 exactly because of rounding off the numbers to two decimal places.

    Sleep Duration of the Subjects by General Characteristics

    Variables Categories Sleep duration (W %)† p
    ≤6 hrs 7 hrs 8 hrs ≥9 hrs
    Total   40.3 30.7 22.7 6.3 ＜.001
    Gender Male 42.1 30.6 21.6 5.7
    Female 38.5 30.7 23.8 6.9
    Age (year) 30~49 38.4 32.3 23.1 6.3 ＜.001
    50~64 44.1 27.5 22.0 6.3
    Marital status Never married 41.5 27.8 24.3 6.4 ＜.001
    Married 39.4 31.6 22.8 6.3
    Divorced, separated 49.2 24.3 20.5 6.0
    Education Elementary school 47.1 24.9 18.4 9.6 ＜.001
    Middle school 43.2 27.5 23.3 6.1
    High school 38.0 31.2 24.2 6.7
    ≥College 39.1 33.9 22.6 4.4
    Household income Low 42.7 26.6 23.0 7.7 ＜.001
    Moderate low 40.5 29.4 23.1 7.0
    Moderate upper 39.2 31.0 23.6 6.2
    Upper 40.3 33.2 21.4 5.2
    Occupation Professional, manager 43.3 33.8 19.6 3.2 ＜.001
    Clerk 41.6 35.2 20.5 2.6
    Service & sales 40.2 31.5 22.7 5.6
    Agricultural, physical worker 42.6 28.4 22.6 6.4
    Medicaid None 36.0 29.5 25.3 9.3 ＜.001
    No 40.2 30.8 22.8 6.3
    Recipients 48.2 26.8 17.3 7.8

    W=weighted.

    †Total percent is not sometimes equal to 100.0 exactly because of rounding off the numbers to two decimal places.

    Logistic Regression for Hypertension

    Variable (reference group)   Odds Lower Upper p
    Gender (Female) Male 1.66 1.48 1.86 ＜.001
    Age group (30~49year) 50~64 year 3.66 3.19 4.20 ＜.001
    Education level (College) Elementary school 1.84 1.51 2.24 ＜.001
    Middle school 1.42 1.17 1.71 ＜.001
    High school 1.26 1.09 1.46 .002
    Household income (upper) Low 1.27 1.04 1.55 .017
    Moderate low 0.90 0.78 1.04 .156
    Moderate upper 1.00 0.86 1.16 .995
    High risk drinking (no) Yes 1.64 1.41 1.92 ＜.001
    Obesity (normal) Underweight 0.59 0.38 0.92 .020
    Overweight 2.41 2.15 2.71 ＜.001
    Sleep duration (8 hours) ≤6 hours 1.16 1.02 1.33 .025
    7 hours 1.07 0.93 1.23 .374
    ≥9 hours 1.04 0.81 1.34 .758
    Table 1. Prevalence of Hypertension by General Characteristics (N=13,230)

    HT=hypertension; W=weighted; BMI=body mass index.

    The difference between N with total n is due to missing value;

    Total percent is not sometimes equal to 100.0 exactly because of rounding off the numbers to two decimal places.

    Table 2. Sleep Duration of the Subjects by General Characteristics

    W=weighted.

    Total percent is not sometimes equal to 100.0 exactly because of rounding off the numbers to two decimal places.

    Table 3. Logistic Regression for Hypertension

    Table 1.

    Table 2.

    Table 3.

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