Prevalence and factors correlated with hypertension secondary from obstructive sleep apnea

  • Sittichai Khamsai Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
  • Pawornwan Mahawarakorn Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
  • Panita Limpawattana Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
  • Jarin Chindaprasirt Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
  • Wattana Sukeepaisarnjaroen Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
  • Songkwan Silaruks Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
  • Vichai Senthong Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
  • Bundit Sawunyavisuth Department of Marketing, Faculty of Business Administration and Accountancy, Khon Kaen University, Khon Kaen, Thailand.
  • Kittisak Sawanyawisuth | kittisak@kku.ac.th Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Abstract

Background: In 2003, the JNC 7 reported obstructive sleep apnea (OSA) as a cause of secondary hypertension. The prevalence of OSA in hypertension ranges from 30-80%. There are limited data on the prevalence and risk factors of OSA in hypertensive patients. This study thus aimed to evaluate prevalence and clinical predictors of obstructive sleep apnea (OSA) in these patients.
Methods: This was a cross-sectional study and conducted at the hypertension clinic at Khon Kaen University’s Srinagarind Hospital, Thailand. We enrolled patients with hypertension treated at the clinic. OSA was defined as apnea-hypopnea index of 5 events/hour or over according to cardiopulmonary monitoring. Patients whose hypertension was due to any other causes were excluded. The prevalence of OSA was calculated and risk factors for OSA were analyzed using multivariate logistic regression.
Results: There were 726 hypertensive patients treated at the clinic. Of those, 253 (34.8%) were randomly studied and categorized as either non-OSA (147 patients, 58.1%) or OSA (106 patients, 41.9%). There were four independent factors associated with OSA-induced hypertension: age, sex, history of snoring, and history of headache. Headache had an adjusted odds ratio (95% confidence interval) of 3.564 (95% confidence interval of 1.510, 8.411).
Conclusion: Age, male sex, history of snoring, and headache were independent predictors of hypertension caused by OSA.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

References

Benjafield AV, Ayas NT, Eastwood PR, Heinzer R, Ip MSM, Morrell MJ, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med 2019;7:687-98. DOI: https://doi.org/10.1016/S2213-2600(19)30198-5

Dong R, Dong Z, Liu H, Shi F, Du J. Prevalence, risk factors, outcomes, and treatment of obstructive sleep apnea in patients with cerebrovascular disease: A systematic review. J Stroke Cerebrovasc Dis 2018;27:1471-80. DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.12.048

Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016;37:2315-81. DOI: https://doi.org/10.1093/eurheartj/ehw106

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003;289:2560-72. DOI: https://doi.org/10.1001/jama.289.19.2560

Patel AR, Patel AR, Singh S, Singh S, Khawaja I. The association of obstructive sleep apnea and hypertension. Cureus 2019;11:e4858. DOI: https://doi.org/10.7759/cureus.4858

Sawanyawisuth K, Chindaprasirt J, Senthong V, Makarawate P, Limpawattana P, Domthong A, et al. Lower BMI is a predictor of obstructive sleep apnea in elderly Thai hypertensive patients. Sleep Breath 2013;17:1215-9. DOI: https://doi.org/10.1007/s11325-013-0826-3

Chirakalwasan N, Teerapraipruk B, Simon R, Hirunwiwatkul P, Jaimchariyatam N, Desudchit T, et al. Comparison of polysomnographic and clinical presentations and predictors for cardiovascular-related diseases between non-obese and obese obstructive sleep apnea among Asians. J Clin Sleep Med 2013;9:553-7. DOI: https://doi.org/10.5664/jcsm.2748

Franklin KA, Lindberg E. Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J Thorac Dis 2015;7:1311-22.

Nigro CA, Dibur E, Borsini E, Malnis S, Ernst G, Bledel I, et al. The influence of gender on symptoms associated with obstructive sleep apnea. Sleep Breath 2018;22:683-93. DOI: https://doi.org/10.1007/s11325-017-1612-4

Johnson RF, Hansen A, Narayanan A, Yogesh A, Shah GB, Mitchell RB. Weight gain velocity as a predictor of severe obstructive sleep apnea among obese adolescents. Laryngoscope 2020;130:1339-42. DOI: https://doi.org/10.1002/lary.28296

Narayanan A, Yogesh A, Mitchell RB, Johnson RF. Asthma and obesity as predictors of severe obstructive sleep apnea in an adolescent pediatric population. Laryngoscope 2020;130:812-7. DOI: https://doi.org/10.1002/lary.28029

Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest 2014;146:1387-94. DOI: https://doi.org/10.1378/chest.14-0970

Nilius G, Domanski U, Schroeder M, Franke KJ, Hogrebe A, Margarit L, et al. A randomized controlled trial to validate the Alice PDX ambulatory device. Nat Sci Sleep 2017;9:171-80. DOI: https://doi.org/10.2147/NSS.S133789

Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, Matheson MC, et al. Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep Med Rev 2017;34:70-81. DOI: https://doi.org/10.1016/j.smrv.2016.07.002

Lo Bue A, Salvaggio A, Insalaco G. Obstructive sleep apnea in developmental age. A narrative review. Eur J Pediatr 2020;179:357-65. DOI: https://doi.org/10.1007/s00431-019-03557-8

Zhou X, Zhou B, Li Z, Lu Q, Li S, Pu Z, Luo F. Gender differences of clinical and polysomnographic findings with obstructive sleep apnea syndrome. Sci Rep 2021;11:5938. DOI: https://doi.org/10.1038/s41598-021-85558-y

Hou H, Zhao Y, Yu W, Dong H, Xue X, Ding J, et al. Association of obstructive sleep apnea with hypertension: A systematic review and meta-analysis. J Glob Health 2018;8:010405. DOI: https://doi.org/10.7189/jogh.08.010405

Xiao M, Tang X, Zhang F, Zhou L, Bu X, Liu X, et al. Association between self-reported snoring and hypertension among Chinese Han population aged 30-79 in Chongqing, China. Environ Health Prev Med 2020;25:78. DOI: https://doi.org/10.1186/s12199-020-00908-y

Lee SK, Choi K, Chang YH, Kim J, Shin C. Increased risk for new-onset hypertension in midlife male snorers: The 14-year follow-up study. J Sleep Res 2019;28:e12757. DOI: https://doi.org/10.1111/jsr.12757

Silverberg DS, Oksenberg A. Are sleep-related breathing disorders important contributing factors to the production of essential hypertension? Curr Hypertens Rep 2001;3:209-15. DOI: https://doi.org/10.1007/s11906-001-0040-8

Russell MB, Kristiansen HA, Kværner KJ. Headache in sleep apnea syndrome: epidemiology and pathophysiology. Cephalalgia 2014;34:752-5. DOI: https://doi.org/10.1177/0333102414538551

Ferini-Strambi L, Lombardi GE, Marelli S, Galbiati A. Neurological deficits in obstructive sleep apnea. Curr Treat Options Neurol 2017;19:16. DOI: https://doi.org/10.1007/s11940-017-0451-8

Jordan J, Shannon JR, Diedrich A, Black B, Costa F, Robertson D, et al. Interaction of carbon dioxide and sympathetic nervous system activity in the regulation of cerebral perfusion in humans. Hypertension 2000;36:383-8. DOI: https://doi.org/10.1161/01.HYP.36.3.383

Earl DE, Lakhani SS, Loriaux DB, Spector AR. Predictors of moderate to severe obstructive sleep apnea: identification of sex differences. Sleep Breath 2019;23:1151-8. DOI: https://doi.org/10.1007/s11325-019-01790-x

KoÇ G, Metİn KM, AkÇay BD, KaradaŞ Ö, Sayin R, Yetkİn S. Relationship between apnea-hypopnea index and oxygen desaturation in REM-sleep period and morning headache in patients with obstructive sleep apnea syndrome. Noro Psikiyatr Ars 2019;57:294-8. DOI: https://doi.org/10.29399/npa.23348

Spałka J, Kędzia K, Kuczyński W, Kudrycka A, Małolepsza A, Białasiewicz P, et al. Morning headache as an obstructive sleep apnea-related symptom among sleep clinic patients-A cross-section analysis. Brain Sci 2020;10:57. DOI: https://doi.org/10.3390/brainsci10010057

Park JW, Mehta S, Fastlicht S, Lowe AA, Almeida FR. Changes in headache characteristics with oral appliance treatment for obstructive sleep apnea. Sci Rep 2021;11:2568. DOI: https://doi.org/10.1038/s41598-021-82041-6

Shao C, Qi H, Lang R, Yu B, Tang Y, Zhang L, et al. Clinical features and contributing factors of excessive daytime sleepiness in chinese obstructive sleep apnea patients: The role of comorbid symptoms and polysomnographic variables. Can Respir J 2019;2019:5476372. DOI: https://doi.org/10.1155/2019/5476372

Hein M, Mungo A, Hubain P, Loas G. Excessive daytime sleepiness in adolescents: current treatment strategies. Sleep Sci 2020;13:157-71.

Gus M, Gonçalves SC, Martinez D, de Abreu Silva EO, Moreira LB, Fuchs SC, et al. Risk for obstructive sleep apnea by Berlin Questionnaire, but not daytime sleepiness, is associated with resistant hypertension: a case-control study. Am J Hypertens 2008;21:832-5. DOI: https://doi.org/10.1038/ajh.2008.184

Lee RW, Vasudavan S, Hui DS, Prvan T, Petocz P, Darendeliler MA, et al. Differences in craniofacial structures and obesity in Caucasian and Chinese patients with obstructive sleep apnea. Sleep 2010;33:1075-80. DOI: https://doi.org/10.1093/sleep/33.8.1075

Genta PR, Marcondes BF, Danzi NJ, Lorenzi-Filho G. Ethnicity as a risk factor for obstructive sleep apnea: comparison of Japanese descendants and white males in São Paulo, Brazil. Braz J Med Biol Res 2008;41:728-33. DOI: https://doi.org/10.1590/S0100-879X2008000800015

Sawunyavisuth B. What are predictors for a continuous positive airway pressure machine purchasing in obstructive sleep apnea patients? Asia Pac J Sci Technol 2018;23:10.

Kingkaew N, Antadech T. Cardiovascular risk factors and 10-year CV risk scores in adults aged 30-70 years old in Amnat Charoen Province, Thailand. Asia Pac J Sci Technol 2019;24:04.

Published
2021-09-10
Info
Issue
Section
Original Research Articles
Keywords:
Age, snoring, predictors, headache
Statistics
  • Abstract views: 1301

  • PDF: 39
  • HTML: 0
How to Cite
Khamsai, S., Mahawarakorn, P., Limpawattana, P., Chindaprasirt, J., Sukeepaisarnjaroen, W., Silaruks, S., Senthong, V., Sawunyavisuth, B., & Sawanyawisuth, K. (2021). Prevalence and factors correlated with hypertension secondary from obstructive sleep apnea. Multidisciplinary Respiratory Medicine, 16. https://doi.org/10.4081/mrm.2021.777