Skip to main content

01.09.2020 | IM - ORIGINAL

How common is obstructive sleep apnea in young hypertensive patients?

verfasst von: Jittirat Jinchai, Sittichai Khamsai, Paiboon Chattakul, Panita Limpawattana, Jarin Chindaprasirt, Verajit Chotmongkol, Songkwan Silaruks, Vichai Senthong, Kittisak Sawanyawisuth

Erschienen in: Internal and Emergency Medicine | Ausgabe 6/2020

Einloggen, um Zugang zu erhalten

Abstract

Obstructive sleep apnea (OSA) has been reported to be a cause of hypertension in 40–80% of hypertensive patients. However, there are limited data available on the prevalence and predictors of OSA in young hypertensive patients. This study was conducted between October 2017 and October 2018. The inclusion criteria were (1) age over 18 and under 35 years (2) diagnosis with hypertension and (3) available respiratory polysomnography results. Patients with other causes of secondary hypertension were excluded. Predictors for OSA were analyzed using multivariate logistic regression analysis. There were 593 consecutive young patients who were diagnosed with hypertension during the study period. Of those, 475 (80.10%) were excluded due to their hypertension having renal causes (429; 90.32%), endocrine-related causes (40; 8.42%), or cardiovascular causes (6; 1.26%). Of the remaining patients (118 patients) who were eligible for the study, 105 (88.98%) of whom were diagnosed with OSA. The median age of the patients with OSA did not differ from those without OSA (29 vs 23 years; p value 0.065). There were two independent predictors for OSA: age and body mass index with adjusted odds ratios (95% confidence interval) of 1.280 (1.049, 1.562) and 1.258 (1.083, 1.462), respectively. In conclusion, after excluding other possible causes of hypertension, we found OSA to be highly prevalent in hypertensive patients younger than 35 years old. Increasing age and high body mass index were predictors for OSA in young hypertensive patients.
Literatur
1.
Zurück zum Zitat Chobanian AV, Bakris GL, Black HR et al (2003) The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA 289:2560–2572CrossRef Chobanian AV, Bakris GL, Black HR et al (2003) The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA 289:2560–2572CrossRef
2.
Zurück zum Zitat Yoon SS, Burt V, Louis T, Carroll MD (2012) Hypertension among adults in the United States, 2009–2010. NCHS Data Brief 107:1–8 Yoon SS, Burt V, Louis T, Carroll MD (2012) Hypertension among adults in the United States, 2009–2010. NCHS Data Brief 107:1–8
3.
Zurück zum Zitat Zhou Y, Jia L, Lu B et al (2017ACC) Updated hypertension prevalence, awareness, and control rates based on the 2017ACC/AHA high blood pressure guideline. J Clin Hypertens (Greenwich) 21(6):758–765CrossRef Zhou Y, Jia L, Lu B et al (2017ACC) Updated hypertension prevalence, awareness, and control rates based on the 2017ACC/AHA high blood pressure guideline. J Clin Hypertens (Greenwich) 21(6):758–765CrossRef
4.
Zurück zum Zitat James PA, Oparil S, Carter BL et al (2014) 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 311:507–520CrossRef James PA, Oparil S, Carter BL et al (2014) 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 311:507–520CrossRef
5.
Zurück zum Zitat Wolk R, Shamsuzzaman AS, Somers VK (2003) Obesity, sleep apnea, and hypertension. Hypertension 42:1067–1074CrossRef Wolk R, Shamsuzzaman AS, Somers VK (2003) Obesity, sleep apnea, and hypertension. Hypertension 42:1067–1074CrossRef
6.
Zurück zum Zitat Calhoun DA (2010) Obstuctive sleep apnea and hypertension. Curr Hypertens Rep 12:189–195CrossRef Calhoun DA (2010) Obstuctive sleep apnea and hypertension. Curr Hypertens Rep 12:189–195CrossRef
7.
Zurück zum Zitat Pensuksan WC, Chen X, Lohsoonthorn V, Lertmaharit S, Gelaye B, Williams MA (2014) High risk for obstructive sleep apnea in relation to hypertension among southeast Asian youngadults: role of obesity as an effect modifier. Am J Hypertens 27:229–236CrossRef Pensuksan WC, Chen X, Lohsoonthorn V, Lertmaharit S, Gelaye B, Williams MA (2014) High risk for obstructive sleep apnea in relation to hypertension among southeast Asian youngadults: role of obesity as an effect modifier. Am J Hypertens 27:229–236CrossRef
8.
Zurück zum Zitat Chirinos JA, Gurubhagavatula I, Teff K et al (2014) CPAP, weight loss, or both for obstructive sleep apnea. N Engl J Med 370(24):2265–2275CrossRef Chirinos JA, Gurubhagavatula I, Teff K et al (2014) CPAP, weight loss, or both for obstructive sleep apnea. N Engl J Med 370(24):2265–2275CrossRef
9.
Zurück zum Zitat Bazzano LA, Khan Z, Reynold K, He J (2007) Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension 50:417–423CrossRef Bazzano LA, Khan Z, Reynold K, He J (2007) Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension 50:417–423CrossRef
10.
Zurück zum Zitat Sawanyawisuth K, Chindaprasirt J, Senthong V et al (2013) Lower BMI is a predictor of obstructive sleep apnea in elderly Thai hypertensive patients. Sleep Breath 17:1215–1219CrossRef Sawanyawisuth K, Chindaprasirt J, Senthong V et al (2013) Lower BMI is a predictor of obstructive sleep apnea in elderly Thai hypertensive patients. Sleep Breath 17:1215–1219CrossRef
11.
Zurück zum Zitat Epstein LJ, Kristo D, Strollo PJ Jr et al (2009) Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 5:263–276CrossRef Epstein LJ, Kristo D, Strollo PJ Jr et al (2009) Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 5:263–276CrossRef
12.
Zurück zum Zitat Parati G, Lombardi C, Hedner J et al (2012) Position paper on the management of patients with obstructive sleep apnea and hypertension: joint recommendations by the European Society of Hypertension, by the European Respiratory Society and by the members of European COST (Cooperation in Scientific and Technological research) ACTION B26 on obstructive sleep apnea. J Hypertens 30:633–646CrossRef Parati G, Lombardi C, Hedner J et al (2012) Position paper on the management of patients with obstructive sleep apnea and hypertension: joint recommendations by the European Society of Hypertension, by the European Respiratory Society and by the members of European COST (Cooperation in Scientific and Technological research) ACTION B26 on obstructive sleep apnea. J Hypertens 30:633–646CrossRef
13.
Zurück zum Zitat Somers VK, White DP, Amin R et al (2008) Sleep apnea and cardiovascular disease: an AHA/ ACC Foundation Scientific Statement from the AHA Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. J Am Coll Cardiol 52:686–717CrossRef Somers VK, White DP, Amin R et al (2008) Sleep apnea and cardiovascular disease: an AHA/ ACC Foundation Scientific Statement from the AHA Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. J Am Coll Cardiol 52:686–717CrossRef
14.
Zurück zum Zitat Hou H, Zhao Y, Yu W et al (2018) Association of obstructive sleep apnea with hypertension: a systematic review and meta-analysis. Association of obstructive sleep apnea with hypertension. J Glob Health 8:010405. Hou H, Zhao Y, Yu W et al (2018) Association of obstructive sleep apnea with hypertension: a systematic review and meta-analysis. Association of obstructive sleep apnea with hypertension. J Glob Health 8:010405.
15.
Zurück zum Zitat Gabb GM, Mangoni AA, Anderson CS et al (2016) Guideline for the diagnosis and management of hypertension in adults—2016. Med J Aust 205:85–89CrossRef Gabb GM, Mangoni AA, Anderson CS et al (2016) Guideline for the diagnosis and management of hypertension in adults—2016. Med J Aust 205:85–89CrossRef
16.
Zurück zum Zitat Muxfeldt ES, Margallo VS, Guimarães GM, Salles GF (2014) Prevalence and associated factors of obstructive sleep apnea in patients with resistanthypertension. Am J Hypertens 27:1069–1078CrossRef Muxfeldt ES, Margallo VS, Guimarães GM, Salles GF (2014) Prevalence and associated factors of obstructive sleep apnea in patients with resistanthypertension. Am J Hypertens 27:1069–1078CrossRef
17.
Zurück zum Zitat Asha’ari ZA, Hasmoni MH, Ab Rahman J, Yusof RA, Ahmad RA (2012) The association between sleep apnea and young adults with hypertension. Laryngoscope 122:2337–2342 Asha’ari ZA, Hasmoni MH, Ab Rahman J, Yusof RA, Ahmad RA (2012) The association between sleep apnea and young adults with hypertension. Laryngoscope 122:2337–2342
18.
Zurück zum Zitat Pensuksan WC, Chen X, Lohsoonthorn V, Lertmaharit S, Gelaye B, Williams MA (2014) High risk for obstructive sleep apnea in relation to hypertension among southeast Asian young adults: role of obesity as an effect modifier. Am J Hyperten 27:229–236CrossRef Pensuksan WC, Chen X, Lohsoonthorn V, Lertmaharit S, Gelaye B, Williams MA (2014) High risk for obstructive sleep apnea in relation to hypertension among southeast Asian young adults: role of obesity as an effect modifier. Am J Hyperten 27:229–236CrossRef
19.
Zurück zum Zitat Franklin KA, Sahlin C, Stenlund H, Lindberg E (2013) Sleep apnoea is a common occurrence in females. Eur Respir J 41:610–615CrossRef Franklin KA, Sahlin C, Stenlund H, Lindberg E (2013) Sleep apnoea is a common occurrence in females. Eur Respir J 41:610–615CrossRef
20.
Zurück zum Zitat Bixler EO, Vgontzas AN, Ten Have T, Tyson K, Kales A (1998) Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med 157:144–148CrossRef Bixler EO, Vgontzas AN, Ten Have T, Tyson K, Kales A (1998) Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med 157:144–148CrossRef
21.
Zurück zum Zitat Lindberg E, Elmasry A, Gislason T et al (1999) Evolution of sleep apnea syndrome in sleepy snorers: a population-based prospective study. Am J Respir Crit Care Med 159:2024–2027CrossRef Lindberg E, Elmasry A, Gislason T et al (1999) Evolution of sleep apnea syndrome in sleepy snorers: a population-based prospective study. Am J Respir Crit Care Med 159:2024–2027CrossRef
22.
Zurück zum Zitat Peppard PE, Young T, Palta M, Dempsey J, Skatrud J (2000) Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA 284:3015–3021CrossRef Peppard PE, Young T, Palta M, Dempsey J, Skatrud J (2000) Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA 284:3015–3021CrossRef
23.
Zurück zum Zitat Grote L, Ploch T, Heitmann J, Knaack L, Penzel T, Peter JH (1999) Sleep-related breathing disorder is an independent risk factor for systemic hypertension. Am J Respir Crit Care Med 160:1875–1882CrossRef Grote L, Ploch T, Heitmann J, Knaack L, Penzel T, Peter JH (1999) Sleep-related breathing disorder is an independent risk factor for systemic hypertension. Am J Respir Crit Care Med 160:1875–1882CrossRef
24.
Zurück zum Zitat Tufik S, Santos-Silva R, Taddei JA, Bittencourt LR (2010) Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study. Sleep Med 11:441–446CrossRef Tufik S, Santos-Silva R, Taddei JA, Bittencourt LR (2010) Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study. Sleep Med 11:441–446CrossRef
25.
Zurück zum Zitat Schaser AJ, Wang H, Volz LM, Connor NP (2011) Biochemistry of the anterior, medial, and posterior genioglossus in the aged rat. Dysphagia 26:256–263CrossRef Schaser AJ, Wang H, Volz LM, Connor NP (2011) Biochemistry of the anterior, medial, and posterior genioglossus in the aged rat. Dysphagia 26:256–263CrossRef
26.
Zurück zum Zitat Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165:1217–1239CrossRef Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165:1217–1239CrossRef
27.
Zurück zum Zitat Chen X, Pensuksan WC, Lohsoonthorn V, Lertmaharit S, Gelaye B, Williams MA (2014) Obstructive sleep apnea and multiple anthropometric indices of general obesity and abdominal obesity among young adults. Int J Soc Sci Stud 2:89–99PubMedPubMedCentral Chen X, Pensuksan WC, Lohsoonthorn V, Lertmaharit S, Gelaye B, Williams MA (2014) Obstructive sleep apnea and multiple anthropometric indices of general obesity and abdominal obesity among young adults. Int J Soc Sci Stud 2:89–99PubMedPubMedCentral
28.
Zurück zum Zitat Nieto FJ, Young TB, Lind BK et al (2000) Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 283:1829–1836CrossRef Nieto FJ, Young TB, Lind BK et al (2000) Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 283:1829–1836CrossRef
29.
Zurück zum Zitat O’Connor GT, Caffo B, Newman AB et al (2009) Prospective study of sleep-disordered breathing and hypertension: the Sleep Heart Health Study. Am J Respir Crit Care Med 179:1159–1164CrossRef O’Connor GT, Caffo B, Newman AB et al (2009) Prospective study of sleep-disordered breathing and hypertension: the Sleep Heart Health Study. Am J Respir Crit Care Med 179:1159–1164CrossRef
30.
Zurück zum Zitat Rajala R, Partinen M, Sane T, Pelkonen R, Huikuri K, Seppalainen AM (1991) Obstructive sleep apnoea syndrome in morbidly obese patients. J Intern Med 230:125–129CrossRef Rajala R, Partinen M, Sane T, Pelkonen R, Huikuri K, Seppalainen AM (1991) Obstructive sleep apnoea syndrome in morbidly obese patients. J Intern Med 230:125–129CrossRef
31.
Zurück zum Zitat Richman RM, Elliott LM, Burns CM, Bearpark HM, Steinbeck KS, Caterson ID (1994) The prevalence of obstructive sleep apnoea in an obese female population. Int J Obes Relat Metab Disord 18:173–177PubMed Richman RM, Elliott LM, Burns CM, Bearpark HM, Steinbeck KS, Caterson ID (1994) The prevalence of obstructive sleep apnoea in an obese female population. Int J Obes Relat Metab Disord 18:173–177PubMed
32.
Zurück zum Zitat McMahon MJ, Sheikh KL, Andrada TF, Holley AB (2017) Using the STOPBANG questionnaire and other pre-test probability tools to predict OSA in younger, thinner patients referred to a sleep medicine clinic. Sleep Breath 21:869–876CrossRef McMahon MJ, Sheikh KL, Andrada TF, Holley AB (2017) Using the STOPBANG questionnaire and other pre-test probability tools to predict OSA in younger, thinner patients referred to a sleep medicine clinic. Sleep Breath 21:869–876CrossRef
33.
Zurück zum Zitat Marrone O, Battaglia S, Steiropoulos P et al (2016) Chronic kidney disease in European patients with obstructive sleep apnea: the ESADA cohort study. J Sleep Res 25:739–745CrossRef Marrone O, Battaglia S, Steiropoulos P et al (2016) Chronic kidney disease in European patients with obstructive sleep apnea: the ESADA cohort study. J Sleep Res 25:739–745CrossRef
34.
Zurück zum Zitat Voulgaris A, Marrone O, Bonsignore MR, Steiropoulos P (2019) Chronic kidney disease in patients with obstructive sleep apnea. A narrative review. Sleep Med Rev 47:74–89CrossRef Voulgaris A, Marrone O, Bonsignore MR, Steiropoulos P (2019) Chronic kidney disease in patients with obstructive sleep apnea. A narrative review. Sleep Med Rev 47:74–89CrossRef
35.
Zurück zum Zitat Phitsanuwong C, Senthong V (2016) CPAP therapy in a young hypertension patient. Asia Pac J Sci Technol 21:APST-21-04-01 Phitsanuwong C, Senthong V (2016) CPAP therapy in a young hypertension patient. Asia Pac J Sci Technol 21:APST-21-04-01
36.
Zurück zum Zitat Sawunyavisuth B (2018) What are predictors for a continuous positive airway pressure machine purchasing in obstructive sleep apnea patients? Asia Pac J Sci Technol 23:APST-23-03-10 Sawunyavisuth B (2018) What are predictors for a continuous positive airway pressure machine purchasing in obstructive sleep apnea patients? Asia Pac J Sci Technol 23:APST-23-03-10
37.
Zurück zum Zitat Kario K (2018) Nocturnal Hypertension New technology and Evidence. Hypertension 71:997–1009CrossRef Kario K (2018) Nocturnal Hypertension New technology and Evidence. Hypertension 71:997–1009CrossRef
38.
Zurück zum Zitat Phitsanuwong C, Ariyanuchitkul S, Chumjan S, Domthong A, Silaruks S, Senthong S (2017) Does hypertensive crisis worsen the quality of life of hypertensive patients with OSA? A pilot study. Asia Pac J Sci Technol 22:APST-22-02-01. Phitsanuwong C, Ariyanuchitkul S, Chumjan S, Domthong A, Silaruks S, Senthong S (2017) Does hypertensive crisis worsen the quality of life of hypertensive patients with OSA? A pilot study. Asia Pac J Sci Technol 22:APST-22-02-01.
Metadaten
Titel
How common is obstructive sleep apnea in young hypertensive patients?
verfasst von
Jittirat Jinchai
Sittichai Khamsai
Paiboon Chattakul
Panita Limpawattana
Jarin Chindaprasirt
Verajit Chotmongkol
Songkwan Silaruks
Vichai Senthong
Kittisak Sawanyawisuth
Publikationsdatum
01.09.2020
Verlag
Springer International Publishing
Erschienen in
Internal and Emergency Medicine / Ausgabe 6/2020
Print ISSN: 1828-0447
Elektronische ISSN: 1970-9366
DOI
https://doi.org/10.1007/s11739-019-02273-3

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.