Is sleep-disordered breathing an independent risk factor for hypertension in the general population (13,057 subjects)?

Objective: Sleep-disordered breathing has been hypothesized to have a close relationship with hypertension but previous studies have reported mixed re sults. This is an important health issue that requires further clarificatio n because of the potential impact on the prevention and control of hyperten sion. Methods: The relationship between hypertension and three forms of sle ep-disordered breathing (chronic snoring, breathing pauses and obstructive sleep apnea syndrome (OSAS)) was assessed using representative samples of t he non-institutionalized population of the UK, Germany and Italy (159 milli on inhabitants). The samples were comprised of 13,057 individuals aged 15-1 00 years who were interviewed about their sleeping habits and their sleep s ymptoms over the telephone using the Sleep-EVAL system. Results: OSAS was f ound in 1.9% (95% CI: 1.2% to 2.3%) of the UK sample, 1.8% (95% CI: 1.4% to 2.2%) of the German sample and 1.1% (95% CI: 0.8% to 1.4%) of the Italian sample. OSAS was an independent risk factor (odds ratio (OR): 9.7) for hype rtension after controlling for possible confounding effects of age, gender, obesity, smoking, alcohol consumption, life stress, and, heart and renal d isease. Conclusions: Results from three of the most populated countries in Western Europe indicate that OSAS is an independent risk factor for hyperte nsion. Snoring and breathing pauses during sleep appeared to be non-signifi cant predictive factors. (C) 2000 Elsevier Science Inc. All rights reserved .