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Abstract
Background Current literature supports cross-sectional association between childhood obstructive sleep apnoea (OSA) and elevated blood pressure (BP). However, long-term cardiovascular outcomes in children with OSA remain unexplored.
Objective To evaluate the associations of childhood OSA with BP parameters in a prospective 10 year follow-up study.
Methods Participants were recruited from a cohort established for our previous OSA epidemiological study. They were invited to undergo clinical examination, overnight polysomnography and 24-hour ambulatory BP monitoring. Multivariate linear regression was used to assess the associations of baseline childhood OSA with BP outcomes at follow-up. Multivariable log-binomial regression was used with inverse probability weighting to assess the adjusted associations of childhood OSA with hypertension and non-dipping of nocturnal BP in adulthood.
Results 243 participants (59% male) attended the follow-up visit. The mean age was 9.8 (SD ±1.8) and 20.2 (SD ±1.9) years at baseline and follow-up respectively, with a mean follow-up duration of 10.4 (SD ±1.1) years. Childhood moderate-to-severe OSA was associated with higher nocturnal systolic blood pressure (SBP) (difference from normal controls: 6.5 mm Hg, 95% CI 2.9 to 10.1) and reduced nocturnal dipping of SBP (−4.1%, 95% CI −6.3% to 1.8%) at follow-up, adjusted for age, sex, Body Mass Index and height at baseline, regardless of the presence of OSA at follow-up. Childhood moderate-to-severe OSA was also associated with higher risk of hypertension (relative risk (RR) 2.5, 95% CI 1.2 to 5.3) and non-dipping of nocturnal SBP (RR 1.3, 95% CI 1.0 to 1.7) at follow-up.
Conclusion Childhood OSA was found to be an independent risk factor for adverse BP outcomes in adulthood.
- sleep apnoea
- clinical epidemiology
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Footnotes
Contributors KCC conceptualised and designed the study; coordinated, supervised and performed the data collection; carried out the data analysis and interpretation; drafted the initial manuscript; revised the manuscript; and approved the final manuscript as submitted. CTA conceptualised and designed the study; coordinated, supervised and performed data collection; carried out the data analysis and interpretation; reviewed and revised the manuscript; and approved the final manuscript as submitted. LLH contributed to the study design, carried out the data analysis and interpretation, reviewed and revised the manuscript, and approved the final manuscript as submitted. YKW contributed to the study design and data interpretation, reviewed and revised the manuscript, and approved the final manuscript as submitted. AML conceptualised and designed the study, coordinated and supervised the data collection, carried out data interpretation, reviewed and revised the manuscript, and approved the final manuscript as submitted. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.
Funding This research project was supported by the Research Grants Council of the Hong Kong Special Administrative Region, China (CUHK 470913).
Disclaimer The funder had no role in study design, data collection and analysis, preparation of the manuscript or in the decision to submit the paper for publication.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The study was approved by the Joint Chinese University of Hong Kong–New Territories East Cluster Research Ethics Committee (CRE-2013–011).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement No data are available. Individual participant data will not be available.