Objective  To explore the relationship between hypertension prevalence and sleep among adult residents in Guangdong province, providing scientific evidence for the control and prevention of hypertension.

Methods Data were collected from 4 982 adult residents aged ≥18 years in 11 monitoring sites of Guangdong province in the 2022 Chinese Nutrition and Health Surveillance. The unconditional multivariate logistic regression model was employed to analyze the relationships of sleep problems and sleep duration with hypertension prevalence among adult residents in Guangdong province.

Results Among the 4 982 adult residents in Guangdong province, there were 2 393 (49.41%) residents without sleep problems and 2 589 (50.59%) residents with sleep problems. Among them, 1 084 (19.65%), 3 168 (66.54%), and 730 (13.81%) residents had insufficient sleep, adequate sleep, and excessive sleep, respectively. There were 1 611 residents with hypertension, and the complex weighted prevalence of hypertension was 30.04%. After adjusting confounding factors such as gender, age, educational background, marital status, place of residence, current smoking, frequency of alcohol consumption, physical activity, family history of hypertension, body mass index, and central obesity, the results of the unconditional multivariate logistic regression analysis showed that the risk of hypertension among adult residents with sleep problems in Guangdong province was 1.237 times (95%CI: 1.122–1.364) that of adults without sleep problems. The risk of hypertension among adult residents aged ≥ 60 years and with sleep problems in this province was 1.468 times (95%CI: 1.183–1.823) that of those without sleep problems. The risk of hypertension among adult residents with excessive sleep was 1.228 times (95%CI: 1.046–1.442) that of those with adequate sleep. For female adult residents with excessive sleep, the risk of hypertension was 1.340 times (95%CI: 1.006–1.786) that of those with adequate sleep. For female adult residents aged ≥ 60 years and with excessive sleep, the risk of hypertension was 1.446 times (95%CI: 1.001–2.088) that of those with adequate sleep.

Conclusions The risk of hypertension increased in adults with sleep problems in Guangdong province, especially in those aged ≥ 60 years. Excessive sleep duration was also associated with increased risk of hypertension, especially in females and the adults aged ≥ 60 years.