期刊
PSYCHOSOMATIC MEDICINE
卷 84, 期 3, 页码 368-373出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PSY.0000000000001045
关键词
social integration; ambulatory blood pressure monitoring; ecological momentary assessment; sleep; actigraphy; nocturnal blood pressure dipping; BP = blood pressure; CVD = cardiovascular disease; DBP = diastolic blood pressure; MAP = mean arterial pressure; SBP = systolic blood pressure; SNI = Social Network Index; WASO = wakefulness after sleep onset
资金
- National Heart, Lung, and Blood Institute [T32HL007560, T32HL082610]
- National Institute on Aging [R01AG041778]
Socially integrated individuals have lower risk of cardiovascular disease, partially due to their greater nocturnal blood pressure dipping, which is explained by better sleep regularity among these individuals.
Objective Socially integrated individuals are at lower risk of cardiovascular disease morbidity and mortality compared with their more isolated counterparts. This association may be due, in part, to the effect of social integration on nocturnal blood pressure (BP) decline or dipping, a physiological process associated with decreased disease risk. However, the pathways linking social integration with nocturnal BP dipping are unknown. We sought to replicate the association between social integration and BP dipping, and to test whether sleep characteristics (duration, regularity, continuity) and/or daily social interactions (frequency, valence) helped to explain the association. Methods A total of 391 healthy midlife adults completed an actigraphy assessment protocol that measured sleep. During four actigraphy assessment days, participants also completed ambulatory BP monitoring and ecological momentary assessment protocols that measured BP and social interactions at regular intervals throughout the day. Social integration was assessed via a questionnaire. Results Linear regression controlling for age, sex, race, education, and body mass index indicated that higher levels of social integration were associated with greater nocturnal BP dipping, as indicated by a smaller ratio of night/day mean arterial pressure (beta = -0.11, p = .031). Analyses of indirect effects suggested that this association was explained, in part, by greater sleep regularity among more integrated individuals. We did not find evidence for other hypothesized indirect effects. Conclusions This was the first study to investigate sleep and social mechanisms underlying the link between social integration and nocturnal BP dipping. Because sleep regularity is modifiable, this pathway represents a potential intervention target to promote nocturnal BP dipping.
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