Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study
Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study
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DOI：
10.1001/jama.283.14.1829
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发表时间：
2000-04-12
影响因子：
120.7
通讯作者：
Pickering, TG
中科院分区：
文献类型：
--
作者：
Nieto, FJ;Young, TB;Pickering, TG
在之前的研究中，睡眠呼吸障碍（SDB）和睡眠呼吸暂停与高血压有关，但这些研究大多使用替代信息来定义SDB（如打鼾），并且基于小的临床人群，或者两者兼而有之。目的探讨中老年人群中SDB与高血压的关系。设计和设置对睡眠心脏健康研究参与者的横断面分析，这是一项1995年11月至1998年1月进行的基于社区的多中心研究。参与者从正在进行的基于人群的研究中招募的6132名受试者（年龄大于或等于40岁，52.8%为女性）。主要观察指标呼吸暂停低通气指数（AHI，每小时睡眠中呼吸暂停加低通气的平均次数，低通气定义为气流减少大于或等于30%或胸腹偏移，并伴有血红蛋白饱和度下降大于或等于4%），由无人值机的家庭多导睡眠图获得。其他测量方法包括兴奋指数；氧饱和度低于90%的睡眠时间百分比；打鼾史；存在高血压，定义为静息血压至少为140/90 mm Hg或使用抗高血压药物。结果平均收缩压和舒张压以及高血压患病率随着SDB测量值的增加而显著升高，尽管这种关联部分可以用体重指数（BMI）来解释。在调整了人口统计学和人体测量变量（包括BMI、颈围和腰臀比）以及饮酒和吸烟后，比较AHI最高类别（大于或等于每小时30）和最低类别(
Context Sleep-disordered breathing (SDB) and sleep apnea have been linked to hypertension in previous studies, but most of these studies used surrogate information to define SDB (eg, snoring) and were based on small clinic populations, or both.Objective To assess the association between SDB and hypertension in a large cohort of middle-aged and older persons.Design and Setting Cross-sectional analyses of participants in the Sleep Heart Health Study, a community-based multicenter study conducted between November 1995 and January 1998.Participants A total of 6132 subjects recruited from ongoing population-based studies (aged greater than or equal to 40 years; 52.8% female).Main Outcome Measures Apnea-hypopnea index (AHI, the average number of apneas plus hypopneas per hour of sleep, with hypopnea defined as a greater than or equal to 30% reduction in airflow or thoracoabdominal excursion accompanied by a greater than or equal to 4% drop in oxyhemoglobin saturation), obtained by unattended home polysomnography. Other measures include arousal index; percentage of sleep time below 90% oxygen saturation; history of snoring; and presence of hypertension, defined as resting blood pressure of at least 140/90 mm Hg or use of antihypertensive medication.Results Mean systolic and diastolic blood pressure and prevalence of hypertension increased significantly with increasing SDB measures, although some of this association was explained by body mass index (BMI). After adjusting for demographics and anthropometric variables (including BMI, neck circumference, and waist-to-hip ratio), as well as for alcohol intake and smoking, the odds ratio for hypertension, comparing the highest category of AHI (greater than or equal to 30 per hour) with the lowest category (