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Untreated sleep apnea may increase odds of hypertension in black adults
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Untreated moderate or severe obstructive sleep apnea is related to increased odds of resistant hypertension in black adults, according to findings published in Circulation.
Researchers assessed whether obstructive sleep apnea (OSA) and its related hypoxemia burden would associate with more severe forms of hypertension.
“There are several studies that have determined that African Americans have the highest prevalence of hypertension and are the most likely to have uncontrolled hypertension compared to other racial/ethnic groups,” Dayna A. Johnson, PhD, MPH, MS, MSW, of the division of sleep and circadian disorders at Brigham and Women’s Hospital, the division of sleep medicine at Harvard Medical School and the department of epidemiology at the Rollins Center of Public Health at Emory University, told Cardiology Today.
The study consisted of 664 black participants from the Jackson Heart Sleep Study from 2012 to 2016 with hypertension (mean age, 65 years; 69% women; 59% obese; 51% college-educated) whose sleep apnea was assessed through an in-home device and BP was measured at a research visit. Researchers identified moderate or severe OSA as a respiratory event index of 15 or more, and nocturnal hypoxemia as percent sleep time with less than 90% oxyhemoglobin saturation.
Covariables such as participants’ age, sex, education and smoking status were obtained through self-report. Other covariables assessed included diabetes, depressive symptoms, perceived stress and sleep duration.
Researchers identified that among the cohort, 25.7% of participants had moderate or severe OSA, which went untreated in 94%. Of the participants with OSA, 48.2% had uncontrolled hypertension and 14.5% had resistant hypertension.
Once adjusted for confounders, participants with moderate or severe OSA had higher odds of resistant hypertension (OR = 2.04; 95% CI, 1.14-3.67) vs. those without it, the researchers wrote. Each standard deviation higher than less than 90% oxyhemoglobin saturation was associated with increased odds of resistant hypertension (OR = 1.25; 95% CI, 1.01-1.55), but OSA and less than 90% oxyhemoglobin saturation were not associated with uncontrolled BP.
The findings are consistent with the other studies that suggested overnight hypoxemia may mediate some CV and metabolic consequences of sleep apnea, the researchers wrote.
Johnson told Cardiology Today that her and her colleagues are conducting more research on the topic by specifically exploring methods for sleep apnea screening using commonly collected health information.
“This study provides evidence suggesting that sleep apnea may be related to resistant hypertension, which is highly prevalent among African Americans,” Johnson told Cardiology Today. “Treating sleep apnea may be an avenue for reducing the burden of uncontrolled hypertension among African Americans, thus narrowing cardiovascular health disparities.” – by Earl Holland Jr.
Disclosures: Johnson reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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