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1 March 1994 | Volume 120 Issue 5 | Pages 382-388
Objective: To measure the independent association of sleep-disordered breathing (sleep apnea and habitual snoring) and hypertension in a healthy adult population.
Design: A cross-sectional study of blood pressure during wakefulness and sleep among participants with and without sleep-disordered breathing.
Setting: Community-based study.
Participants: 147 men and women, aged 30 to 60 years, selected from Wisconsin State employees enrolled in the Wisconsin Sleep Cohort Study, an ongoing, prospective, epidemiologic study of sleep-disordered breathing.
Measurements: Sleep and medical history interview, nocturnal polysomnography, and 24-hour ambulatory blood pressure monitoring in all participants.
Results: Mean blood pressures were significantly higher among participants with sleep apnea (
Conclusions: Our data indicate an association between hypertension and sleep apnea independent of obesity, age, and sex in a nonselected, community-based adult population.
Author and Article Information
From the University of Wisconsin School of Medicine, Madison, Wisconsin.
ARTICLE
Sleep Apnea and Hypertension: A Population-based Study
5 apneas or hypopneas per hour of sleep) compared with those without (131/80 ±1.7/1.1 mm Hg compared with 122/75 ±1.9/1.2 mm Hg during wakefulness and 113/66 ±1.8/1.1 mm Hg compared with 104/62 ±2/1.3 mm Hg during sleep, respectively; P < 0.05). The variability of the blood pressure during sleep was significantly greater in participants with sleep apnea or a history of snoring compared with those without (P < 0.05). After controlling for obesity, age, and sex, sleep apnea was significantly associated with hypertension in a dose-response fashion, with odds ratios ranging from 2.0 for 5 apneic or hypopneic episodes per hour of sleep to 5.0 for 25 apneic or hypopneic episodes.
Requests for Reprints: Khin Mae Hla, MD, MHS, Department of Medicine, University of Wisconsin, Clinical Science Center, J5/210, 600 Highland Avenue, Madison, WI, 53792.
Acknowledgments: The authors thank Claire Falk, Julie Dohr, and Ann Andre for technical assistance.
Grant Support: By National Institutes of Health grant PO1 HL 42242 and by grant RR 03186 from the Department of Veterans Affairs Medical Research Service.
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E. Lindberg, C. Janson, K. Svärdsudd, T. Gislason, J. Hetta, and G. Boman Increased mortality among sleepy snorers: a prospective population based study Thorax, August 1, 1998; 53(8): 631 - 637. [Abstract] [Full Text]
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D. A. Katz and C. A. McHorney Clinical Correlates of Insomnia in Patients With Chronic Illness Arch Intern Med, May 25, 1998; 158(10): 1099 - 1107. [Abstract] [Full Text] [PDF]
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C. L. MARCUS, M. G. GREENE, and J. L. CARROLL Blood Pressure in Children with Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., April 1, 1998; 157(4): 1098 - 1103. [Abstract] [Full Text] [PDF]
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T. Young, P. Peppard, M. Palta, K. M. Hla, L. Finn, B. Morgan, and J. Skatrud Population-Based Study of Sleep-Disordered Breathing as a Risk Factor for Hypertension Arch Intern Med, August 11, 1997; 157(15): 1746 - 1752. [Abstract] [PDF]
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M. KAMBA, Y. SUTO, Y. OHTA, Y. INOUE, and E. MATSUDA Cerebral Metabolism in Sleep Apnea . Evaluation by Magnetic Resonance Spectroscopy Am. J. Respir. Crit. Care Med., July 1, 1997; 156(1): 296 - 298. [Abstract] [Full Text]
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S. Zinkovska and D. A. Kirby Intracerebroventricular propranolol prevented vascular resistance increases on arousal from sleep apnea J Appl Physiol, May 1, 1997; 82(5): 1637 - 1643. [Abstract] [Full Text] [PDF]
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J. Wright, R. Johns, I. Watt, A. Melville, and T. Sheldon Health effects of obstructive sleep apnoea and the effectiveness of continuous positive airways pressure: a systematic review of the research evidence BMJ, March 22, 1997; 314(7084): 851 - 851. [Abstract] [Full Text]
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M. M Ohayon, C. Guilleminault, R. G Priest, and M. Caulet Snoring and breathing pauses during sleep: telephone interview survey of a United Kingdom population sample BMJ, March 22, 1997; 314(7084): 860 - 860. [Abstract] [Full Text]
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E. M. Ball, R. D. Simon Jr, A. A. Tall, M. B. Banks, G. Nino-Murcia, and W. C. Dement Diagnosis and Treatment of Sleep Apnea Within the Community: The Walla Walla Project Arch Intern Med, February 24, 1997; 157(4): 419 - 424. [Abstract] [PDF]
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C. J. WORSNOP, M. T. NAUGHTON, C. E. BARTER, T. O. MORGAN, A. I. ANDERSON, and R. J. PIERCE The Prevalence of Obstructive Sleep Apnea in Hypertensives Am. J. Respir. Crit. Care Med., January 1, 1997; 157(1): 111 - 115. [Abstract] [Full Text]
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Statement on Health Outcomes Research in Sleep Apnea THIS OFFICIAL STATEMENT WAS APPROVED BY THE ATS BOARD OF DIRECTORS, JUNE 1997 Am. J. Respir. Crit. Care Med., January 1, 1997; 157(1): 335 - 341. [Full Text]
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M. Leroy, C. Van Surell, R. Pilliere, M.-P. Hagenmuller, P. Aegerter, B. Raffestin, and A. Foucher Short-term Variability of Blood Pressure During Sleep in Snorers With or Without Apnea Hypertension, December 1, 1996; 28(6): 937 - 943. [Abstract] [Full Text]
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D. C. Good, J. Q. Henkle, D. Gelber, J. Welsh, and S. Verhulst Sleep-Disordered Breathing and Poor Functional Outcome After Stroke Stroke, February 1, 1996; 27(2): 252 - 259. [Abstract] [Full Text]
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 P. J. Strollo and R. M. Rogers Obstructive Sleep Apnea N. Engl. J. Med., January 11, 1996; 334(2): 99 - 104. [Full Text] [PDF]
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