TY - JOUR
T1 - Mild-to-moderate sleep apnea is associated with incident hypertension
T2 - Age effect
AU - Vgontzas, Alexandros N.
AU - Li, Yun
AU - He, Fan
AU - Fernandez-Mendoza, Julio
AU - Gaines, Jordan
AU - Liao, Duanping
AU - Basta, Maria
AU - Bixler, Edward O.
N1 - Funding Information:
This study was supported by National Heart Lung and Blood Institute (NHLBI) R01 HL40916 and HL5193. Conflict of interest statement. None declared.
Publisher Copyright:
© 2018 Sleep Research Society. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Study Objectives Mild-to-moderate obstructive sleep apnea (OSA) is highly prevalent in the general population; however, previous studies on its association with incident hypertension are mixed. We examined the association between mild and moderate OSA and incident hypertension in a large random general population sample. Methods From 1741 adults of the Penn State Cohort, 744 adults without hypertension or severe OSA (i.e. apnea/hypopnea index [AHI] ≥ 30 events/hour) were followed-up after 9.2 years. Mild OSA was defined as an AHI of 5 to 14.9 events/hour (n = 71), while moderate OSA as an AHI of 15 to 29.9 events/hour (n = 32). Incident hypertension was defined by a self-report of receiving antihypertensive medication and/or history of a diagnosis since their baseline study. Results After adjusting for multiple potential confounders, mild-to-moderate OSA was significantly associated with increased risk of incident hypertension (overall hazard ratio [HR] = 2.94, 95% confidence interval (CI) = 1.96-4.41; HR = 3.24, 95% CI = 2.08-5.03 for mild OSA and HR = 2.23, 95% CI = 1.10-4.50 for moderate OSA). Importantly, this association was modified by age (p-interaction < 0.05); while strong in young and middle-aged adults (HR = 3.62, 95% CI = 2.34-5.60), the association was lost in adults older than 60 years (HR = 1.36 95% CI = 0.50-3.72). Furthermore, the association of mild-to-moderate OSA with components of metabolic syndrome was strongest in young and middle-aged adults. Conclusions Mild-to-moderate OSA, even when asymptomatic, is associated with increased risk of incident hypertension, but the strength of association significantly decreases with age. Although older participants with asymptomatic mild-to-moderate OSA are not at significant risk of developing hypertension, early detection and intervention, including improving metabolic indices, is especially warranted in young and middle-aged adults.
AB - Study Objectives Mild-to-moderate obstructive sleep apnea (OSA) is highly prevalent in the general population; however, previous studies on its association with incident hypertension are mixed. We examined the association between mild and moderate OSA and incident hypertension in a large random general population sample. Methods From 1741 adults of the Penn State Cohort, 744 adults without hypertension or severe OSA (i.e. apnea/hypopnea index [AHI] ≥ 30 events/hour) were followed-up after 9.2 years. Mild OSA was defined as an AHI of 5 to 14.9 events/hour (n = 71), while moderate OSA as an AHI of 15 to 29.9 events/hour (n = 32). Incident hypertension was defined by a self-report of receiving antihypertensive medication and/or history of a diagnosis since their baseline study. Results After adjusting for multiple potential confounders, mild-to-moderate OSA was significantly associated with increased risk of incident hypertension (overall hazard ratio [HR] = 2.94, 95% confidence interval (CI) = 1.96-4.41; HR = 3.24, 95% CI = 2.08-5.03 for mild OSA and HR = 2.23, 95% CI = 1.10-4.50 for moderate OSA). Importantly, this association was modified by age (p-interaction < 0.05); while strong in young and middle-aged adults (HR = 3.62, 95% CI = 2.34-5.60), the association was lost in adults older than 60 years (HR = 1.36 95% CI = 0.50-3.72). Furthermore, the association of mild-to-moderate OSA with components of metabolic syndrome was strongest in young and middle-aged adults. Conclusions Mild-to-moderate OSA, even when asymptomatic, is associated with increased risk of incident hypertension, but the strength of association significantly decreases with age. Although older participants with asymptomatic mild-to-moderate OSA are not at significant risk of developing hypertension, early detection and intervention, including improving metabolic indices, is especially warranted in young and middle-aged adults.
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U2 - 10.1093/sleep/zsy265
DO - 10.1093/sleep/zsy265
M3 - Article
C2 - 30590811
AN - SCOPUS:85064112070
SN - 0161-8105
VL - 42
JO - Sleep
JF - Sleep
IS - 4
M1 - zsy265
ER -