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  • Special Issue: Current evidence and perspectives for hypertension management in Asia
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Intraindividual correlations between nocturnal urination frequency and sleep blood pressure: the Nagahama Study

Hypertension Research volume 48, pages 994–1002 (2025)Cite this article

A Comment to this article was published on 05 February 2025

Abstract

Nocturnal urination frequency is associated with sleep blood pressure (BP). However, it was uncertain to what extent the sleep BP increases within individuals with each increase in the number of nocturnal urination. We calculated intraindividual differences in sleep BP between nights with different urination frequencies to clarify their relationship. We enrolled 2418 community residents (mean age, 61.1 years). Participants wore a cuff on the upper arm when sleeping that automatically measured BP at fixed times during a 1-week period. The frequency of nocturnal urination was recorded in a sleep diary by the study participants. Sleep systolic BP increased with increased nocturnal urination frequency (0 time vs. 1 time, Δ2.1 mmHg, P < 0.001; 1 time vs. 2 times, Δ1.8 mmHg, P < 0.001; 2 times vs. ≥3 times, Δ1.4 mmHg, P = 0.012), and a similar association was observed for sleep diastolic BP. These associations were independent of age, the use of antihypertensive drugs reduced renal function, and the presence of sleep-disordered breathing. Sleep BP in participants who experienced nocturnal urination 0, 1, and 2 times during the 1-week measurement period showed a linear increase with the frequency of urination (0 time vs. 2 times: systolic BP, Δ4.7 mmHg; diastolic BP, Δ3.1 mmHg; P < 0.001). There was an intraindividual correlation between nocturnal urination frequency and sleep BP. These correlations were independent of baseline BP and participants’ clinical backgrounds. Nocturnal urination frequency may be an indicator of individuals who require detailed ambulatory BP measurement.

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Acknowledgements

We are extremely grateful to the Nagahama City Office and the nonprofit organization Zeroji Club for their assistance in conducting the Nagahama study. We also thank the editors of Crimson Interactive Pvt. Ltd. for their help in English language editing.

Funding

The study was supported by a university grant, The Center of Innovation Program, The Global University Project, and a Grant-in-Aid for Scientific Research (25293141, 26670313, 26293198, 17H04182, 17H04126, 21H04850) from the Ministry of Education, Culture, Sports, Science and Technology of Japan; the Practical Research Project for Rare/Intractable Diseases (ek0109070, ek0109283, ek0109196, ek0109348), the Comprehensive Research on Aging and Health Science Research Grants for Dementia R&D (dk0207006, dk0207027), the Program for an Integrated Database of Clinical and Genomic Information (kk0205008), the Practical Research Project for Lifestyle-related Diseases including Cardiovascular Diseases and Diabetes Mellitus (ek0210066, ek0210096, ek0210116), the Research Program for Health Behavior Modification by Utilizing IoT (le0110005), and the Research and Development Grants for Longevity Science (dk0110040) from the Japan Agency for Medical Research and Development (AMED); Welfare Sciences Research Grants, Research on Region Medical from the Ministry of Health, Labor and Welfare of Japan; the Takeda Medical Research Foundation, Daiwa Securities Health Foundation, Sumitomo Foundation, and the Mitsubishi Foundation.

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Authors and Affiliations

  1. Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, Japan

    Yasuharu Tabara & Kazuya Setoh

  2. Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan

    Yasuharu Tabara, Takahisa Kawaguchi, Kazuo Chin & Fumihiko Matsuda

  3. Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan

    Takeshi Matsumoto, Kimihiko Murase & Toyohiro Hirai

  4. Department of Human Health Science, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan

    Tomoko Wakamura

  5. Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine, Nihon University of Medicine, Itabashi-ku, Tokyo, Japan

    Kazuo Chin

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  1. Yasuharu Tabara
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Correspondence to Yasuharu Tabara.

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Conflict of interest

The Department of Respiratory Care and Sleep Control Medicine at Kyoto University is funded by endowments from Philips Respironics, Fukuda Denshi, Fukuda Lifetec-Keiji, and ResMed to Kyoto University. The Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine, Nihon University of Medicine is funded by endowments from Philips Respironics, Fukuda Denshi, Fukuda Lifetec-Tokyo, and ResMed to Nihon University.

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Tabara, Y., Matsumoto, T., Murase, K. et al. Intraindividual correlations between nocturnal urination frequency and sleep blood pressure: the Nagahama Study. Hypertens Res 48, 994–1002 (2025). https://doi.org/10.1038/s41440-024-02085-9

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