Objectives Compelling evidence from laboratory-based and population-based studies link sleep loss to negative cardiovascular health outcomes. However, little is known about the association between sleep duration and hypertension in primary care health settings, independently of other well controlled clinical and biochemical characteristics. We investigated the association between sleep duration and the prevalence of hypertension adjusting for 21 potential confounding factors in a noncontrolled primary care sample. Methods The sample included 1046 French adults older than 40 years (mean age, 55.5 years), who visited any of the general practitioners of primary care centers in the Paris area. Blood pressure (BP) readings, blood samples and standardized health and sleep questionnaires were performed on each participant. Hypertension inclusion criteria were either high BP measurements (SBP ≥140 μmmHg or DBP ≥90 μmmHg) or the use of antihypertensive medications. Sleep duration was recorded as the self-reported average number of hours of sleep per night during the week. Logistic regressions were performed to test the association between hypertension and sleep duration adjusted for sociodemographic, clinical, biochemical, lifestyle, psychological and sleep disorder covariates. Results Compared to the group sleeping 7 h, individuals sleeping 5 h or less had an increased odds ratio (OR) for the prevalence of hypertension [OR = 1.80, 95% confidence interval (1.06-3.05)], after adjusting for 21 potential confounders which did not markedly attenuate this association. Conslusions Our data provide further epidemiologic evidence that with no specific selection in primary care medicine, usual short-sleep duration increases the risk of hypertension prevalence in adults over 40 years. Objectives Compelling evidence from laboratory-based and population-based studies link sleep loss to negative cardiovascular health outcomes. We investigated the association between sleep duration and the prevalence of hypertension adjusting for 21 potential confounding factors in a noncontrolled primary care sample. Methods The sample included 1046 French adults older than 40 years (mean age, 55.5 years), who visited any of the general Hypertension inclusion criteria were either high BP measurements (SBP ≥140 μmmHg or DBP ≥90 μmmHg) or the use of antihypertensive medications. Sleep duration was reco rded as the self-reported average number of hours of sleep per night during the week. Logistic regressions were performed to test the association between hypertension and sleep duration adjusted for sociodemographic, clinical, biochemical, lifestyle, psychological and sleep disorder covariates. the group sleeping 7 h, individuals sleeping 5 h or less had an increased odds ratio (OR) for the prevalence of hypertension [OR = 1.80, 95% confidence interval (1.06-3.05)], after adjusting for 21 potential confounders which did not markedly attenuate this association. Conslusions Our data provide further epidemiologic evidence that with no specific selection in primary care medicine, usual short-sleep duration increases the risk of hypertension prevalence in adults over 40 years.