Association of hypertension and sleep-disordered breathing
Association of hypertension and sleep-disordered breathing
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DOI：
10.1001/archinte.160.15.2289
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发表时间：
2000-08-14
影响因子：
--
通讯作者：
Kales, A
中科院分区：
文献类型：
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作者：
Bixler, EO;Vgontzas, AN;Kales, A
背景资料：据我们所知，在调整年龄、体重指数、sere、绝经和激素替代治疗、种族、饮酒和吸烟等可能的混杂因素后，尚未在来自广泛年龄范围的普通人群的受试者中评估睡眠呼吸障碍（SDB）与高血压之间的关联。方法：在这项研究的第一阶段，我们采访了4364名男性和12219名女性，年龄在20到100岁之间。在这项研究的第二阶段，741名男性和1000名女性，以前采访，选择的基础上存在的SDB的危险因素（打鼾，白天嗜睡，肥胖，高血压，和女性，更年期）。研究第二阶段选择的每例受试者均提供了全面的病史，接受了体格检查，并在睡眠实验室进行了1晚的评估。在SDB的严重程度方面，确定了4组：中度或重度（阻塞性呼吸暂停/低通气指数大于或等于15.0），轻度（打鼾和阻塞性呼吸暂停/低通气指数为0.1-14.9），打鼾，没有SDB，对照组。这种关联的强度随着年龄的增长而下降，并与SDB的严重程度成正比。在最佳拟合模型中，无论是性别还是绝经都没有改变高血压和SDB.Conclusions之间的关系：在这项研究的结果中，SDB，甚至打鼾，在男性和女性中与高血压独立相关。这种关系在年轻受试者中最强，特别是体重正常的受试者，这一发现与以前的发现一致，即SDB在年轻人中更严重。
Background: To our knowledge, the association between sleep-disordered breathing (SDB) and hypertension has not been evaluated in subjects from the general population with a wide age range while adjusting for the possible confounding factors of age, body mass index, sere, menopause and use of hormone replacement therapy, race, alcohol use, and smoking.Methods: In the first phase of this study, we interviewed 4364 men and 12219 women, aged 20 to 100 years. In the second phase of this study, 741 men and 1000 women, previously interviewed, were selected based on the presence of risk factors for SDB (snoring, day-time sleepiness, obesity, hypertension, and, for women, menopause). Each subject selected for the second phase of the study provided a comprehensive history, underwent a physical examination, and was evaluated for 1 night in the sleep laboratory. In terms of severity of SDB, 4 groups were identified: moderate or severe (obstructive apnea/hypopnea index greater than or equal to 15.0), mild (snoring and an obstructive apnea/hypopnea index of 0.1-14.9), snoring, and no SDB, the control group.Results: Sleep-disordered breathing was independently associated with hypertension when potential confounders were controlled for in the logistic regression analysis. The strength of this association decreased with age and was proportional to the severity of SDB. In the best-fitted model, neither sex nor menopause changed the relationship between hypertension and SDB.Conclusions: In the results of this study, SDB, even snoring, was independently associated with hypertension in both men and women. This relationship was strongest in young subjects, especially those of normal weight, a finding that is consistent with previous findings that SDB is more severe in young individuals.