期刊
CIRCULATION
卷 111, 期 5, 页码 614-621出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/01.CIR.0000154540.62381.CF
关键词
epidemiology; hypertension; risk factors; sleep apnea syndromes
资金
- NHLBI NIH HHS [U01HL64360, U01HL53937, U01HL63463, U01HL63429, U01HL53938, U01HL53940, U01HL53941, U01HL53934, U01HL53931, U01HL53916] Funding Source: Medline
Background - Sleep-disordered breathing (SDB) is associated with hypertension in the middle-aged. The association is less clear in older persons. Most middle-aged hypertensives have systolic/diastolic hypertension, whereas isolated systolic hypertension (ISH) is common among persons over 60 years. Mechanistically, only systolic/diastolic hypertension is expected to be associated with SDB, but few studies of SDB and hypertension distinguish systolic/diastolic hypertension from ISH. Prior investigations may have underestimated an association between SDB and systolic/diastolic hypertension in the elderly by categorizing individuals with ISH as simply hypertensive. Methods and Results - We conducted cross-sectional analyses of 6120 participants in the Sleep Heart Health Study, stratified by age: 40 to 59 (n = 2477) and greater than or equal to60 years. Outcome measures included apnea-hypopnea index (AHI; average number of apneas plus hypopneas per hour of sleep), systolic/diastolic hypertension (greater than or equal to140 and greater than or equal to90 mm Hg), and ISH (greater than or equal to140 and <90 mm Hg). With adjustment for covariates, ISH was not associated with SDB in either age category. In those aged <60 years, AHI was significantly associated with higher odds of systolic/diastolic hypertension (AHI 15 to 29.9, OR = 2.38 [95% CI 1.30 to 4.38]; AHI greater than or equal to30, OR = 2.24 [95% CI 1.10 to 4.54]). Among those aged greater than or equal to60 years, no adjusted association between AHI and systolic/diastolic hypertension was found. Conclusions - SDB is associated with systolic/diastolic hypertension in those aged <60 years. No association was found between SDB and systolic/diastolic hypertension in those aged >= 60 years or between SDB and ISH in either age category. These findings have implications for SDB screening and treatment. Distinguishing between hypertensive subtypes reveals a stronger association between SDB and hypertension for those aged <60 years than previously reported.
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