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Multicenter Study Journal Article Ppublish 4 citations

PubMed: 37969034 DOI: 10.1111/cts.13631

Factors influencing new-onset hypertension in elderly patients with obstructive sleep apnea: A multicenter cohort study.

Clin Transl Sci 16(12):2507-2518

Authors: LiBo Zhao, YingHui Gao, WeiHao Xu, KaiLiang Li, Lin Liu, Li Fan

Affiliations

  • Cardiology Department of the Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
  • Sleep Center, Peking University International Hospital, Beijing, China.
  • Cardiology Department of Guangdong Provincial People's Hospital, Guangzhou, China.
  • Health Service Department of the Guard Bureau of the General Office of the Central Committee of the Communist Party of China, Beijing, China.
  • Department of Pulmonary and Critical Care Medicine of the Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.

Abstract

Investigating the influencing factors of new-onset hypertension in the elderly with obstructive sleep apnea (OSA). 450 Chinese older patients with OSA who were non-hypertensive at baseline were enrolled. All patients had undergone polysomnography monitoring in the multicenter study. The primary endpoint was incident hypertension. Kaplan-Meier survival analysis was performed, and multivariate Cox proportional hazards models were generated to determine the factors influencing new-onset hypertension. A total of 176 (39.1%) patients developed hypertension. The hypertension group had older age, higher hemoglobin (Hb) level and apnea-hypopnea index (AHI) values than the non-hypertension group (all p < 0.05). During the median 33-month follow-up period, multivariate Cox analysis showed age (hazard ratio (HR) = 1.039, 95% confidence interval (95% CI): 1.016-1.062), AHI (HR = 1.015, 95% CI: 1.007-1.023) and Hb level (HR = 1.016, 95% CI: 1.008-1.025) were independent predictors of new-onset hypertension. However, continuous positive airway pressure (CPAP; HR = 0.508, 95% CI: 0.271-0.951) reduced the risk of developing hypertension. Notably, the subgroup analysis demonstrated that the plasma glucose level (HR = 1.168, 95% CI: 1.029-1.326) was a risk factor for male patients. Besides length of time with the pulse oxygen saturation less than 90% (Tsat90; HR = 1.005, 95% CI: 1.003-1.007), body mass index (BMI; HR = 1.170, 95% CI: 1.043-1.311), and dyslipidemia (HR = 2.335, 95% CI: 1.144-4.766) had statistically significant effects on the incidence of hypertension in certain subgroups. Although this study lacked analysis of items such as living habits and medication, it did show age, AHI, Hb and CPAP affected the development of hypertension in elderly OSA patients. These findings suggested that targeted interventions in specific populations may be more effective in preventing hypertension.

MeSH

Hypertension, Sleep Apnea, Obstructive, Biomedical Research, Sleep, Apnea, Cohort Studies, Aged, Sleep Apnea Syndromes

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