Association of hypertension and sleep-disordered breathing

Background: To our knowledge, the association between sleep-disordered brea thing (SDB) and hypertension has not been evaluated in subjects from the ge neral population with a wide age range while adjusting for the possible con founding factors of age, body mass index, sere, menopause and use of hormon e replacement therapy, race, alcohol use, and smoking. Methods: In the first phase of this study, we interviewed 4364 men and 1221 9 women, aged 20 to 100 years. In the second phase of this study, 741 men a nd 1000 women, previously interviewed, were selected based on the presence of risk factors for SDB (snoring, day-time sleepiness, obesity, hypertensio n, and, for women, menopause). Each subject selected for the second phase o f the study provided a comprehensive history, underwent a physical examinat ion, and was evaluated for 1 night in the sleep laboratory. In terms of sev erity of SDB, 4 groups were identified: moderate or severe (obstructive apn ea/hypopnea index greater than or equal to 15.0), mild (snoring and an obst ructive apnea/hypopnea index of 0.1-14.9), snoring, and no SDB, the control group. Results: Sleep-disordered breathing was independently associated with hyper tension when potential confounders were controlled for in the logistic regr ession analysis. The strength of this association decreased with age and wa s proportional to the severity of SDB. In the best-fitted model, neither se x nor menopause changed the relationship between hypertension and SDB. Conclusions: In the results of this study, SDB, even snoring, was independe ntly associated with hypertension in both men and women. This relationship was strongest in young subjects, especially those of normal weight, a findi ng that is consistent with previous findings that SDB is more severe in you ng individuals.