Subjective sleep quality, blood pressure, and hypertension: a meta-analysis

J Clin Hypertens (Greenwich). 2018 Mar;20(3):592-605. doi: 10.1111/jch.13220. Epub 2018 Feb 19.


Sleep quality is an important aspect of sleep, but no meta-analysis has elucidated its relationship with blood pressure (BP) and hypertension. A meta-analysis was conducted in October 2016 using multiple databases, including Embase and Medline. Studies that assessed subjective sleep quality and BP or hypertension were included. Upon full-text evaluation, 29 articles from 45 041 patients were selected, of which 22 articles were included in the meta-analysis and seven were presented narratively. Poor sleep quality was significantly associated with a greater likelihood of hypertension (odds ratio, 1.48; P value = .01). Poor sleepers had higher average systolic BP (mean difference = 4.37, P value = .09) and diastolic BP (mean difference = 1.25, P value = .32) than normal sleepers without statistical significance. Patients with hypertension had significantly worse sleep quality scores (mean difference = 1.51, P value < .01), while BP dippers had significantly better scores (mean difference = -1.67, P value < .01). The findings highlight the relationship between sleep quality and hypertension.

Keywords: blood pressure; hypertension; meta-analysis; sleep quality.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Blood Pressure
  • Blood Pressure Determination
  • Female
  • Humans
  • Hypertension / epidemiology*
  • Male
  • Sleep Wake Disorders / epidemiology*