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How common is obstructive sleep apnea in young hypertensive patients?

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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.

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References

  1. 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 289:2560–2572

    Article  CAS  Google Scholar 

  2. Yoon SS, Burt V, Louis T, Carroll MD (2012) Hypertension among adults in the United States, 2009–2010. NCHS Data Brief 107:1–8

    Google Scholar 

  3. 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):758–765

    Article  Google Scholar 

  4. 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 311:507–520

    Article  CAS  Google Scholar 

  5. Wolk R, Shamsuzzaman AS, Somers VK (2003) Obesity, sleep apnea, and hypertension. Hypertension 42:1067–1074

    Article  CAS  Google Scholar 

  6. Calhoun DA (2010) Obstuctive sleep apnea and hypertension. Curr Hypertens Rep 12:189–195

    Article  Google Scholar 

  7. 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 27:229–236

    Article  Google Scholar 

  8. Chirinos JA, Gurubhagavatula I, Teff K et al (2014) CPAP, weight loss, or both for obstructive sleep apnea. N Engl J Med 370(24):2265–2275

    Article  Google Scholar 

  9. 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 50:417–423

    Article  CAS  Google Scholar 

  10. 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 17:1215–1219

    Article  Google Scholar 

  11. 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 5:263–276

    Article  Google Scholar 

  12. 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 30:633–646

    Article  CAS  Google Scholar 

  13. 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 52:686–717

    Article  Google Scholar 

  14. 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. Gabb GM, Mangoni AA, Anderson CS et al (2016) Guideline for the diagnosis and management of hypertension in adults—2016. Med J Aust 205:85–89

    Article  Google Scholar 

  16. Muxfeldt ES, Margallo VS, Guimarães GM, Salles GF (2014) Prevalence and associated factors of obstructive sleep apnea in patients with resistanthypertension. Am J Hypertens 27:1069–1078

    Article  CAS  Google Scholar 

  17. 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. 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 27:229–236

    Article  Google Scholar 

  19. Franklin KA, Sahlin C, Stenlund H, Lindberg E (2013) Sleep apnoea is a common occurrence in females. Eur Respir J 41:610–615

    Article  Google Scholar 

  20. 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 157:144–148

    Article  CAS  Google Scholar 

  21. 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 159:2024–2027

    Article  CAS  Google Scholar 

  22. Peppard PE, Young T, Palta M, Dempsey J, Skatrud J (2000) Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA 284:3015–3021

    Article  CAS  Google Scholar 

  23. 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 160:1875–1882

    Article  CAS  Google Scholar 

  24. Tufik S, Santos-Silva R, Taddei JA, Bittencourt LR (2010) Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study. Sleep Med 11:441–446

    Article  Google Scholar 

  25. Schaser AJ, Wang H, Volz LM, Connor NP (2011) Biochemistry of the anterior, medial, and posterior genioglossus in the aged rat. Dysphagia 26:256–263

    Article  Google Scholar 

  26. Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165:1217–1239

    Article  Google Scholar 

  27. 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 2:89–99

    PubMed  PubMed Central  Google Scholar 

  28. 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 283:1829–1836

    Article  CAS  Google Scholar 

  29. 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 179:1159–1164

    Article  Google Scholar 

  30. Rajala R, Partinen M, Sane T, Pelkonen R, Huikuri K, Seppalainen AM (1991) Obstructive sleep apnoea syndrome in morbidly obese patients. J Intern Med 230:125–129

    Article  CAS  Google Scholar 

  31. 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 18:173–177

    CAS  PubMed  Google Scholar 

  32. 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 21:869–876

    Article  Google Scholar 

  33. 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 25:739–745

    Article  Google Scholar 

  34. Voulgaris A, Marrone O, Bonsignore MR, Steiropoulos P (2019) Chronic kidney disease in patients with obstructive sleep apnea. A narrative review. Sleep Med Rev 47:74–89

    Article  Google Scholar 

  35. Phitsanuwong C, Senthong V (2016) CPAP therapy in a young hypertension patient. Asia Pac J Sci Technol 21:APST-21-04-01

  36. 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. Kario K (2018) Nocturnal Hypertension New technology and Evidence. Hypertension 71:997–1009

    Article  CAS  Google Scholar 

  38. 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.

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Acknowledgements

The authors would like to thank Dr. Dylan Southard (USA) for his kind manuscript editing. The authors also would like to thank Sleep Apnea Research Group, and Division of Research Affair, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (IN63113).

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Authors and Affiliations

  1. Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand

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

  2. Sleep Apnea Research Group, and Research Center in Back, Neck and Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand

    Jittirat Jinchai & Kittisak Sawanyawisuth

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  1. Jittirat Jinchai
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  2. Sittichai Khamsai
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  4. Panita Limpawattana
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  9. Kittisak Sawanyawisuth
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Correspondence to Kittisak Sawanyawisuth.

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The study protocol was approved by the ethic committee in human research, Khon Kaen University, Thailand (HE611131).

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Jinchai, J., Khamsai, S., Chattakul, P. et al. How common is obstructive sleep apnea in young hypertensive patients?. Intern Emerg Med 15, 1005–1010 (2020). https://doi.org/10.1007/s11739-019-02273-3

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