Sleep Deprivation, Endothelial Dysfunction and Hypertension: A Narrative Review

Area of Science:

• Cardiovascular Science
• Sleep Medicine
• Endocrinology

Background:

• Sleep deprivation (SD) is increasingly recognized for its detrimental effects on cardiovascular health.
• Endothelial dysfunction and elevated blood pressure are significant risk factors for hypertension.
• Understanding the mechanistic link between SD and hypertension is crucial for developing effective interventions.

Purpose of the Study:

• To review the impact of sleep deprivation on vascular endothelial cells and blood pressure.
• To synthesize the mechanistic pathways linking sleep deprivation to hypertension.
• To propose sleep deprivation as a modifiable target for hypertension management.

Main Methods:

• A comprehensive literature search was performed across major scientific databases (PubMed, Web of Science, Embase, Medline).
• Studies published up to October 2025 were systematically reviewed.
• Evidence was synthesized to examine sleep deprivation-induced endothelial dysfunction and its role in blood pressure regulation.

Main Results:

• Both acute and chronic sleep deprivation induce endothelial impairment and sustained blood pressure elevation.
• Key mechanisms include vasomotor imbalance, sympathetic hyperactivation, inflammation, oxidative stress, metabolic disturbances, and circadian misalignment.
• Sleep deprivation is identified as a significant, modifiable risk factor for endothelial dysfunction and hypertension.

Conclusions:

• Sleep deprivation significantly contributes to endothelial dysfunction and hypertension through various mechanistic pathways.
• Targeting sleep deprivation presents a promising therapeutic strategy for hypertension management.
• Further research is needed to elucidate underlying mechanisms and develop effective interventions for sleep-compromised populations.