Prevalence of sleep apnoea and snoring in hypertensive men: a population based study

Abstract

Background: Several studies have reported an association between sleep disordered breathing (SDB) and hypertension (HT) but there is still a debate as to whether this is an effect of confounders. Some researchers have found an age dependent relationship between SDB and HT with higher risk at lower ages. A case-control study was performed in hypertensive men and non-hypertensive male controls matched for age and body mass index to assess whether there is an independent association between SDB and HT. If so, we further wanted to investigate whether this effect is age dependent. Methods: An overnight sleep study was performed in a population based, age stratified sample of 102 hypertensive men aged 43-82 years and 102 non-hypertensive controls. Results: Hypertensive subjects had a significantly higher prevalence of SDB than non-hypertensive subjects (apnoea-hypopnoea index (AHI): 10.8 v 7.3; desaturation index (DI): 8.5 v 5.2; AHI >10: 37% v 24%, p<0.05; DI >10: 29% v 12%; lowest desaturation: mean (SD) 81.9 (7.3) v 84.7 (6.1), p<0.01). After adjusting for neck circumference and physical inactivity, DI >10 and lowest desaturation were still independent predictors of HT with adjusted odds ratios of 2.3 (95% CI 1.0 to 5.3) and 0.94 (95% CI 0.89 to 0.99), respectively. When the subjects were split into two groups according to age (<60 and >60 years), the influence of DI >10 on HT was strongest in the younger men (adjusted OR 4.3 (95% CI 1.0 to 19.3 v 2.1 (95% CI 0.7 to 6.5)) and the association between minimum oxygen saturation (SaO 2 ) and HT reached statistical significance in the younger men only. Conclusion: SDB is more prevalent in men with HT than in controls. DI >10 and lowest desaturation are independent predictors of HT irrespective of confounders. The results indicate that the influence of SDB on HT is more pronounced in younger and middle aged men than in those above 60 years.

Sleep-disordered breathing and hypertension among African Americans

“…41 That the hypertensive patients reporting a positive family history were characterized by a greater number of oxygen desaturations and AHI than those typified only by a current diagnosis of hypertension supports our hypothesis. This evidences that hypertensive patients with a positive family history are likely to show a profile of greater blood pressure, higher BMI, and more severe SDB, which by all accounts are more common among African Americans.…”

Multimodal detection of sleep apnoea using electrocardiogram and oximetry signals

“…It is well documented that sleep apnoea impacts significantly on the cardiovascular system and that many sufferers of cardiovascular disease have associated sleep apnoea (Nieto et al 2000;Newman et al 2001;Phillips & Somers 2002;Sjostrom et al 2002;Shamsuzzaman et al 2003;McNicholas et al 2007).…”

The Effects of Continuous Positive Airway Pressure on Prehypertension and Masked Hypertension in Men With Severe Obstructive Sleep Apnea

“…First, OSA is common among patients with hypertension with an estimated prevalence ranging between 38% and 82%. 6,28,29 Second, several risk factors previously identified for prehypertension 1 and masked hypertension, 27 including increasing age, male gender, physical inactivity, use of alcohol, diabetes, history of stroke, and coronary heart disease, overlap with the typical risk factors for OSA. Third, the pathophysiological mechanisms linking OSA to sustained hypertension, including sympathetic overactivation, oxidative stress, systemic inflammation, and increased arterial stiffness, 7 may also be causal mechanisms linking OSA to prehypertension and masked hypertension.…”