Chest
Volume 99, Issue 4, April 1991, Pages 861-866
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Clinical Investigations
Daytime Hypertension in Obstructive Sleep Apnea: Prevalence and Contributing Risk Factors

https://doi.org/10.1378/chest.99.4.861Get rights and content

We examined the prevalence of daytime hypertension in a modern sample of patients with obstructive sleep apnea (OSA) and assessed the relative risk factors contributing to the development of hypertension in this disorder. Daytime hypertension was present in 92 (45 percent) of 206 male and female patients with OSA. Stepwise logistic regression revealed that only age and body mass index (BMI) were predictors of hypertension in this population. A subsample of 152 male patients with OSA was then compared to 904 men identified from a geographically and ethnically similar general population. When one controlled for age and BMI, the prevalence of hypertension in the two groups was the same except for those aged 25 to 44 years who were markedly obese (BMI >31 kg/m2). In this group, 47 percent of the patients with OSA were hypertensive vs 26 percent of control subjects (p<0.05). Our data suggest that the high prevalence of hypertension in OSA is primarily related to age and the excess obesity seen in these patients. In morbidly obese young patients with OSA, factors directly related to OSA may also be contributing to the development of hypertension. With increasing age, other competitive risks may obscure any independent effect that OSA may exert.

Section snippets

Part A

The records from all patients evaluated at the Sleep Apnea Laboratory at Rhode Island Hospital from January 1986 until December 1987 were reviewed. Two hundred six consecutive adult patients from Rhode Island and southeastern Massachusetts with OSA and no other sleep pathology were identified. All had undergone at least one night of standard polysomnographic testing in the laboratory, during which sleep was monitored with an electroencephalogram, two electro-oculograms, and a submental EMG.

Bart A

The population with OSA consisted of 33 female patients and 173 male patients. The characteristics of the group as a whole included an AHI of 48.5 ± 2.4 events per hour, an oxygen saturation baseline of 94.4 ± 0.2 percent, and a saturation nadir of 79.7 ± 0.8 percent. The mean age was 49.4 ± 0.8 years, and the BMI was 33.6 ± 0.5 kg/m2. The characteristics of the male and female patients were similar, although the women tended to be older (53.1 ± 1.8 vs 48.6 ± 0.9 years) and more obese (36.5 ±

Discussion

In this study, we attempted to determine the prevalence of hypertension in a recently evaluated population of patients with OSA. The first 206 adult patients with OSA studied in the only sleep laboratory in Rhode Island were included in this analysis. In this group of patients with moderately severe OSA, we found a prevalence of definite plus borderline hypertension of 45 percent, which is comparable although slightly less than some of the previous reports of OSA populations.

Using stepwise

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    Manuscript received June 15; revision accepted September 17.

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