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Clinical Features of Obstructive Sleep Apnea That Determine Its High Prevalence in Resistant Hypertension.

Min HJ, Cho YJ, Kim CH, Kim da H, Kim HY, Choi JI, Lee JG, Park S, Cho HJ - Yonsei Med. J. (2015)

Bottom Line: Therefore, we aimed to determine the clinical, laboratory, and polysomnographic features of resistant HTN that are significantly associated with OSA.The risk factors for the occurrence of OSA in controlled and resistant hypertensive patients were compared, and independent risk factors that are associated with OSA were analyzed.Age, body mass index, neck circumference, waist circumference, and hip circumference were significantly higher in OSA.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: Resistant hypertension (HTN) occurs in 15-20% of treated hypertensive patients, and 70-80% of resistant hypertensive patients have obstructive sleep apnea (OSA). The characteristics of resistant HTN that predispose patients to OSA have not been reported. Therefore, we aimed to determine the clinical, laboratory, and polysomnographic features of resistant HTN that are significantly associated with OSA.

Materials and methods: Hypertensive patients (n=475) who underwent portable polysomnography were enrolled. The patients were categorized into controlled (n=410) and resistant HTN (n=65) groups. The risk factors for the occurrence of OSA in controlled and resistant hypertensive patients were compared, and independent risk factors that are associated with OSA were analyzed.

Results: Out of 475 patients, 359 (75.6%) were diagnosed with OSA. The prevalence of OSA in resistant HTN was 87.7%, which was significantly higher than that in controlled HTN (73.7%). Age, body mass index, neck circumference, waist circumference, and hip circumference were significantly higher in OSA. However, stepwise multivariate analyses revealed that resistant HTN was not an independent risk factor of OSA.

Conclusion: The higher prevalence and severity of OSA in resistant HTN may be due to the association of risk factors that are common to both conditions.

No MeSH data available.


Related in: MedlinePlus

Severity of OSA in HTN. The apnea-hypopnea index (AHI) was used to determine the prevalence and severity of OSA in controlled and resistant hypertensive patients. (A) The prevalence of OSA in controlled, resistant, and total hypertensive patients was compared. (B) The average AHIs of non-OSA, mild, moderate, and severe degrees of OSA are represented as mean±standard deviation in the controlled and resistant HTN groups. (C) The percentages of patients with non-OSA, mild, moderate, and severe OSA were compared between the controlled and resistant HTN groups (*p<0.05). OSA, obstructive sleep apnea; HTN, hypertension.
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Figure 2: Severity of OSA in HTN. The apnea-hypopnea index (AHI) was used to determine the prevalence and severity of OSA in controlled and resistant hypertensive patients. (A) The prevalence of OSA in controlled, resistant, and total hypertensive patients was compared. (B) The average AHIs of non-OSA, mild, moderate, and severe degrees of OSA are represented as mean±standard deviation in the controlled and resistant HTN groups. (C) The percentages of patients with non-OSA, mild, moderate, and severe OSA were compared between the controlled and resistant HTN groups (*p<0.05). OSA, obstructive sleep apnea; HTN, hypertension.

Mentions: OSA, which was characterized by an AHI≥5, was diagnosed in 73.7% (302/410) and 87.7% (57/65) of patients in the controlled and resistant HTN groups, respectively (Table 2, Fig. 2A). Overall, 359 hypertensive patients (75.6%) were diagnosed with OSA (Table 2, Fig. 2A). The prevalence of OSA in resistant hypertensive patients was significantly higher than that in controlled hypertensive patients (p=0.015) (Fig. 2A). When we used the AHI to categorize the severity of OSA as mild, moderate, or severe, the resistant HTN group had a higher percentage of moderate (35.4% vs. 23.2%) and severe (26.1% vs. 19.5%) OSA patients, compared to the controlled HTN group (Fig. 2B and C).


Clinical Features of Obstructive Sleep Apnea That Determine Its High Prevalence in Resistant Hypertension.

Min HJ, Cho YJ, Kim CH, Kim da H, Kim HY, Choi JI, Lee JG, Park S, Cho HJ - Yonsei Med. J. (2015)

Severity of OSA in HTN. The apnea-hypopnea index (AHI) was used to determine the prevalence and severity of OSA in controlled and resistant hypertensive patients. (A) The prevalence of OSA in controlled, resistant, and total hypertensive patients was compared. (B) The average AHIs of non-OSA, mild, moderate, and severe degrees of OSA are represented as mean±standard deviation in the controlled and resistant HTN groups. (C) The percentages of patients with non-OSA, mild, moderate, and severe OSA were compared between the controlled and resistant HTN groups (*p<0.05). OSA, obstructive sleep apnea; HTN, hypertension.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4541655&req=5

Figure 2: Severity of OSA in HTN. The apnea-hypopnea index (AHI) was used to determine the prevalence and severity of OSA in controlled and resistant hypertensive patients. (A) The prevalence of OSA in controlled, resistant, and total hypertensive patients was compared. (B) The average AHIs of non-OSA, mild, moderate, and severe degrees of OSA are represented as mean±standard deviation in the controlled and resistant HTN groups. (C) The percentages of patients with non-OSA, mild, moderate, and severe OSA were compared between the controlled and resistant HTN groups (*p<0.05). OSA, obstructive sleep apnea; HTN, hypertension.
Mentions: OSA, which was characterized by an AHI≥5, was diagnosed in 73.7% (302/410) and 87.7% (57/65) of patients in the controlled and resistant HTN groups, respectively (Table 2, Fig. 2A). Overall, 359 hypertensive patients (75.6%) were diagnosed with OSA (Table 2, Fig. 2A). The prevalence of OSA in resistant hypertensive patients was significantly higher than that in controlled hypertensive patients (p=0.015) (Fig. 2A). When we used the AHI to categorize the severity of OSA as mild, moderate, or severe, the resistant HTN group had a higher percentage of moderate (35.4% vs. 23.2%) and severe (26.1% vs. 19.5%) OSA patients, compared to the controlled HTN group (Fig. 2B and C).

Bottom Line: Therefore, we aimed to determine the clinical, laboratory, and polysomnographic features of resistant HTN that are significantly associated with OSA.The risk factors for the occurrence of OSA in controlled and resistant hypertensive patients were compared, and independent risk factors that are associated with OSA were analyzed.Age, body mass index, neck circumference, waist circumference, and hip circumference were significantly higher in OSA.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: Resistant hypertension (HTN) occurs in 15-20% of treated hypertensive patients, and 70-80% of resistant hypertensive patients have obstructive sleep apnea (OSA). The characteristics of resistant HTN that predispose patients to OSA have not been reported. Therefore, we aimed to determine the clinical, laboratory, and polysomnographic features of resistant HTN that are significantly associated with OSA.

Materials and methods: Hypertensive patients (n=475) who underwent portable polysomnography were enrolled. The patients were categorized into controlled (n=410) and resistant HTN (n=65) groups. The risk factors for the occurrence of OSA in controlled and resistant hypertensive patients were compared, and independent risk factors that are associated with OSA were analyzed.

Results: Out of 475 patients, 359 (75.6%) were diagnosed with OSA. The prevalence of OSA in resistant HTN was 87.7%, which was significantly higher than that in controlled HTN (73.7%). Age, body mass index, neck circumference, waist circumference, and hip circumference were significantly higher in OSA. However, stepwise multivariate analyses revealed that resistant HTN was not an independent risk factor of OSA.

Conclusion: The higher prevalence and severity of OSA in resistant HTN may be due to the association of risk factors that are common to both conditions.

No MeSH data available.


Related in: MedlinePlus