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Age-dependent associations between sleep-disordered breathing and hypertension: importance of discriminating between systolic/diastolic hypertension and isolated systolic hypertension in the Sleep Heart Health Study.
Tuesday,2012-11-06 12:07 America/Los_Angeles — eenright
| Title | Age-dependent associations between sleep-disordered breathing and hypertension: importance of discriminating between systolic/diastolic hypertension and isolated systolic hypertension in the Sleep Heart Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2005 |
| Authors | Haas, DC, Foster, GL, F Nieto, J, Redline, S, Resnick, HE, Robbins, JA, Young, T, Pickering, TG |
| Journal | Circulation |
| Volume | 111 |
| Issue | 5 |
| Pagination | 614-21 |
| Date Published | 2005 Feb 08 |
| ISSN | 1524-4539 |
| Keywords | Adult, Age Factors, Aged, Antihypertensive Agents, Cross-Sectional Studies, Diastole, Female, Humans, Hypertension, Male, Middle Aged, Risk Factors, Sleep Apnea Syndromes, Sleep Apnea, Central, Systole |
| Abstract | <p><b>BACKGROUND: </b>Sleep-disordered breathing (SDB) is associated with hypertension in the middle-aged. The association is less clear in older persons. Most middle-aged hypertensives have systolic/diastolic hypertension, whereas isolated systolic hypertension (ISH) is common among persons over 60 years. Mechanistically, only systolic/diastolic hypertension is expected to be associated with SDB, but few studies of SDB and hypertension distinguish systolic/diastolic hypertension from ISH. Prior investigations may have underestimated an association between SDB and systolic/diastolic hypertension in the elderly by categorizing individuals with ISH as simply hypertensive.</p><p><b>METHODS AND RESULTS: </b>We conducted cross-sectional analyses of 6120 participants in the Sleep Heart Health Study, stratified by age: 40 to 59 (n=2477) and > or =60 years. Outcome measures included apnea-hypopnea index (AHI; average number of apneas plus hypopneas per hour of sleep), systolic/diastolic hypertension (> or =140 and > or =90 mm Hg), and ISH (> or =140 and <90 mm Hg). With adjustment for covariates, ISH was not associated with SDB in either age category. In those aged<60 years, AHI was significantly associated with higher odds of systolic/diastolic hypertension (AHI 15 to 29.9, OR=2.38 [95% CI 1.30 to 4.38]; AHI > or =30, OR=2.24 [95% CI 1.10 to 4.54]). Among those aged > or =60 years, no adjusted association between AHI and systolic/diastolic hypertension was found.</p><p><b>CONCLUSIONS: </b>SDB is associated with systolic/diastolic hypertension in those aged <60 years. No association was found between SDB and systolic/diastolic hypertension in those aged > or =60 years or between SDB and ISH in either age category. These findings have implications for SDB screening and treatment. Distinguishing between hypertensive subtypes reveals a stronger association between SDB and hypertension for those aged <60 years than previously reported.</p> |
| DOI | 10.1161/01.CIR.0000154540.62381.CF |
| Alternate Journal | Circulation |
| PubMed ID | 15699282 |
| Grant List | U01HL53916 / HL / NHLBI NIH HHS / United States U01HL53931 / HL / NHLBI NIH HHS / United States U01HL53934 / HL / NHLBI NIH HHS / United States U01HL53937 / HL / NHLBI NIH HHS / United States U01HL53938 / HL / NHLBI NIH HHS / United States U01HL53940 / HL / NHLBI NIH HHS / United States U01HL53941 / HL / NHLBI NIH HHS / United States U01HL63429 / HL / NHLBI NIH HHS / United States U01HL63463 / HL / NHLBI NIH HHS / United States U01HL64360 / HL / NHLBI NIH HHS / United States |