Associations between actigraphy‐derived rest–activity rhythm characteristics and hypertension in United States adults

Summary People with disrupted circadian rhythms, such as shift workers, have shown a higher risk of hypertension. However, it is unclear whether more subtle differences in diurnal rest–activity rhythms in the population are associated with hypertension. Clarifying the association between the rest–activity rhythm, a modifiable behavioural factor, and hypertension could provide insight into preventing hypertension and possibly cardiovascular diseases. In this study, we investigated the association between rest–activity rhythm characteristics and hypertension in a large representative sample of United States adults. Cross‐sectional data were obtained from the National Health and Nutrition Examination Survey 2011–2014 ( N = 6726; mean range age 49 20–79 years; 52% women). Five rest–activity rhythm parameters (i.e., pseudo F statistic, amplitude, mesor, amplitude:mesor ratio, and acrophase) were derived from 24‐h actigraphy data using the extended cosine model. We performed multiple logistic regression to assess the associations between the rest–activity rhythm parameters and hypertension. Subgroup analysis stratified by age, gender, race/ethnicity, body mass index and diabetes status was also conducted. A weakened overall rest–activity rhythm, characterised by a lower F statistic, was associated with higher odds of hypertension (odds ratio quintile 1 versus quintile 5 OR Q1vs.Q5 1.61, 95% confidence interval CI 1.26–2.05; p trend < 0.001). Similar results were found for lower amplitude (OR Q1vs.Q5 1.51, 95% CI 1.13–2.03; p trend = 0.01) and amplitude:mesor ratio (OR Q1vs.Q5 1.34, 95% CI 1.01–1.78; p trend = 0.03). The results were robust to the adjustment of confounders, individual behaviours including physical activity levels and sleep duration and appeared consistent across subgroups. Possible interaction between the rest–activity rhythm and body mass index was found. Our results support an association between weakened rest–activity rhythms and higher odds of hypertension.