Key result
Nocturia frequency of ≥3 voids was associated with a 9.6 mm Hg increase in nighttime systolic BP and an 8.5 mm Hg increase in sleep systolic BP (P<0.001 for both).
Why the study?
Blood pressure during sleep is known to be affected by sleep disturbance, prompting an investigation into the effect of nocturia and self-reported poor sleep on blood pressure using an accelerometer-equipped multisensor monitoring device.
Do nocturia and poor sleep quality increase sleep blood pressure in hypertensive patients?
Observational (n=1,252)
Do nocturia and poor sleep quality increase sleep blood pressure in hypertensive patients?
Nocturia has a significant impact on increasing blood pressure during sleep in hypertensive patients, independent of physical activity.
Nocturia-linked sleep BP rise should not yet change hypertension care; leaves open causality and intervention effects.
BACKGROUND: Blood pressure (BP) during sleep is known to be affected by sleep disturbance, including nocturia and sleep disorders. This study investigated the effect of nocturia and self-reported poor sleep on BP using a multisensor BP monitoring device (TM-2441; A&D Co) equipped with an accelerator. METHODS: This analysis is part of the HI-JAMP study (Home-Activity ICT-based Japan Ambulatory Blood Pressure Monitoring Prospective), in which 24-hour ambulatory BP monitoring with simultaneously monitored physical activity using a multisensor all-in-one device was performed in hypertensive patients taking at least 1 antihypertensive agent. Sleep time, awake time, nocturia frequency, and sleep assessment on the ambulatory BP monitoring night were collected from a self-report diary. Nighttime BP was defined as the BP measured between self-reported sleep and awakening times. Sleep BP was defined as the BP without physical activity during a sleep period. RESULTS: Data of 1252 individuals (mean age, 67.4±11.7 years; mean body mass index, 24.8±3.9 kg/m 2 ; 58.2% male) were analyzed. Averages of sleep systolic BP (SBP) were lower than those of nighttime SBP (113.9±15.8 versus 115.2±15.5 mm Hg; P <0.001). Frequency of nocturnal voids was associated with an increase in nighttime systolic SBP (1–2×: 4.7 mm Hg, P <0.001; ≥3×: 9.6 mm Hg, P <0.001) and sleep SBP (1–2×: 4.1 mm Hg, P <0.001; ≥3×: 8.5 mm Hg, P <0.001). Self-reported poor sleep showed a marginal association with increased nighttime SBP but was not associated with sleep SBP. CONCLUSIONS: Compared with self-reported poor sleep, nocturia had a greater impact on BP during sleep, even after excluding BP readings with nocturnal physical activity. REGISTRATION: https://www.umin.ac.jp ; Unique identifier: UMIN000029151.
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Tomitani et al. (2025) conducted an observational in Hypertension (n=1,252). Nocturia and self-reported poor sleep vs. Fewer or no nocturnal voids / good sleep was evaluated on Nighttime and sleep systolic blood pressure (p=<0.001). Nocturia frequency of ≥3 voids was associated with a 9.6 mm Hg increase in nighttime systolic BP and an 8.5 mm Hg increase in sleep systolic BP (P<0.001 for both).
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