Prospective study of sleep-disordered breathing and hypertension: The sleep heart health study

George T. O'Connor, Brian Caffo, Anne B. Newman, Stuart F. Quan, David M. Rapoport, Susan Redline, Helaine E. Resnick, Jonathan Samet, Eyal Shahar

Research output: Contribution to journalArticle

246 Scopus citations

Abstract

Rationale: Cross-sectional epidemiologic studies show an association between sleep-disordered breathing and hypertension, but only one cohort study has examined sleep-disordered breathing as a risk factor for incident hypertension. Objectives: To examine whether sleep-disordered breathing increases the risk of incident hypertension among persons 40 years of age and older. Methods: In a prospective cohort study, we analyzed data from 2,470 participants who at baseline did not have hypertension, defined as blood pressure of at least 140/90 mm Hg or taking antihypertensive medication. The apnea-hypopnea index (AHI), the number of apneas plus hypopneas per hour of sleep, was measured by overnight in-home polysomnography. We estimated odds ratios for developing hypertension during 5 years of follow-up according to baseline AHI. Measurements and Main Results: The odds ratios for incident hypertension increased with increasing baseline AHI; however, this relationship was attenuated and not statistically significant after adjustment for baseline body-mass index. Although not statistically significant, the observed association between a baseline AHI greater than 30 and future hypertension (odds ratio, 1.51; 95% confidence interval, 0.93-2.47) does not exclude the possibility of amodest association. Conclusions: Among middle-aged and older persons without hypertension, much of the relationship between AHI and risk of incident hypertension was accounted for by obesity. After adjustment for body mass index, the AHI was not a significant predictor of future hypertension, although a modest influence of an AHI greater than 30 on hypertension could not be excluded.

Original languageEnglish (US)
Pages (from-to)1159-1164
Number of pages6
JournalAmerican journal of respiratory and critical care medicine
Volume179
Issue number12
DOIs
StatePublished - Jun 15 2009

Keywords

  • Cohort study
  • Hypertension
  • Sleep apnea
  • Sleep-disordered breathing

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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