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Original Research |

Sleep Apnea and Hypertension: Are there gender differences? The Vitoria Sleep Cohort

Irene Cano-Pumarega, MD; Ferrán Barbé, MD, PhD; Andrés Esteban, MD, PhD; Montserrat Martínez-Alonso, PhD; Carlos Egea, MD, PhD; Joaquín Durán-Cantolla, MD, PhD
Author and Funding Information

FUNDING/SUPPORT: This study was supported by Fondo de Investigaciones Sanitarias, Ministerio de Sanidad y Consumo (FIS 01/1577), Departamento de Sanidad del Gobierno Vasco (2001 1037) and Spanish Respiratory Foundation (FEPAR 2001).

STATEMENT OF INTEREST: None declared.

1Respiratory Department. University Hospital of Getafe, Madrid, Spain

2Universidad Europea de Madrid, Madrid, Spain

3Respiratory Department. IRBLleida, Lleida, Spain

4Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES). ISCIII, Madrid, Spain

5University Hospital of Getafe, Madrid, Spain

6Biostatistics Unit. Group of Translational Research in Respiratory Medicine, IRBLleida, Lleida, Spain

7Sleep Unit. OSI Araba University Hospital, Vitoria, Spain

8Research Department. OSI Araba University Hospital, Vitoria, Spain

9Bioaraba Research Institute. Vitoria, Spain

10Universidad del País Vasco, Vitoria, Spain

Correspondence to: Irene Cano Pumarega, MD, Respiratory Department. Hospital Universitario de Getafe. Ctra. Toledo Km 12,500. 28905 Getafe, Madrid (Spain).


Copyright 2017, . All Rights Reserved.


Chest. 2017. doi:10.1016/j.chest.2017.03.008
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Abstract

Background  Evidence from longitudinal studies has reported contradictory results regarding the association between obstructive sleep apnea (OSA) and hypertension. In a previous analysis of the Vitoria Sleep Cohort, we evaluated the relationship between OSA and the risk of developing hypertension and we did not find an independent association after adjustment for confounding factors. In the present study, we perform a post hoc analysis to assess the association between OSA and incident stage 2 hypertension (systolic blood pressure ≥ 160 mmHg and/or diastolic blood pressure ≥ 100 mmHg) based on gender differences.

Methods  A prospective study was performed over 7.5 ± 0.8 years on a middle-aged general population, which included 1,155 normotensive subjects (43.7% men) who completed the follow-up. Blood pressure measurements (at baseline and follow up) and polygraphy at baseline were performed. Logistic regression models were used to determine the association between the respiratory disturbance index (RDI) and stage 2 hypertension and a recursive partitioning method was used to determine the variables related to the incidence of stage 2 hypertension. The RDI was divided into subgroups (0-2.9, 3-6.9, 7-13.9 and ≥14), using the first subgroup as reference.

Results  For men, an RDI ≥ 14 was associated with a significantly increased odds ratio (OR) for stage 2 hypertension [OR = 2.54 (95% CI 1.09-5.95), p = 0.032]. This association was not statistically significant among women (p = 0.371).

Conclusions  Our results suggest an association between moderate to severe OSA and the incidence of more severe forms of hypertension in men but not in women. However, as this is a community-based study, our women’s population characteristics may differ from women usually seen in sleep-disorders clinics.


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