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Cited by 65Obstructive Sleep Apnea ResearchSleep and related disordersBlood Pressure and Hypertension Studies

Mild-to-moderate sleep apnea is associated with incident hypertension: age effect

Open access
Vgontzas, Alexandros N, Li, Yun, He, Fan, Fernandez-Mendoza, Julio, Gaines, Jordan, Liao, Duanping, Basta, Maria, Bixler, Edward O·2019·Sleep
DOI 10.1093/sleep/zsy265PMC PMC7182129
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Abstract

STUDY OBJECTIVES: Mild-to-moderate obstructive sleep apnea (OSA) is highly prevalent in the general population; however, previous studies on its association with incident hypertension are mixed. We examined the association between mild and moderate OSA and incident hypertension in a large random general population sample. METHODS: From 1741 adults of the Penn State Cohort, 744 adults without hypertension or severe OSA (i.e. apnea/hypopnea index [AHI] ≥ 30 events/hour) were followed-up after 9.2 years. Mild OSA was defined as an AHI of 5 to 14.9 events/hour (n = 71), while moderate OSA as an AHI of 15 to 29.9 events/hour (n = 32). Incident hypertension was defined by a self-report of receiving antihypertensive medication and/or history of a diagnosis since their baseline study. RESULTS: After adjusting for multiple potential confounders, mild-to-moderate OSA was significantly associated with increased risk of incident hypertension (overall hazard ratio [HR] = 2.94, 95% confidence interval (CI) = 1.96-4.41; HR = 3.24, 95% CI = 2.08-5.03 for mild OSA and HR = 2.23, 95% CI = 1.10-4.50 for moderate OSA). Importantly, this association was modified by age (p-interaction < 0.05); while strong in young and middle-aged adults (HR = 3.62, 95% CI = 2.34-5.60), the association was lost in adults older than 60 years (HR = 1.36 95% CI = 0.50-3.72). Furthermore, the association of mild-to-moderate OSA with components of metabolic syndrome was strongest in young and middle-aged adults. CONCLUSIONS: Mild-to-moderate OSA, even when asymptomatic, is associated with increased risk of incident hypertension, but the strength of association significantly decreases with age. Although older participants with asymptomatic mild-to-moderate OSA are not at significant risk of developing hypertension, early detection and intervention, including improving metabolic indices, is especially warranted in young and middle-aged adults.

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Crossref · 10.1093/sleep/zsy265

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  • Incident hypertension has also been independently associated with mild obstructive sleep apnea, especially in patients aged less than 60 years.

    “Incident hypertension has also been independently associated with mild OSA, especially in patients aged <60 years (Vgontzas et al., 2019).”

    From Obstructive sleep apnea: transition from pathophysiology to an integrative disease model (2022) · cites this paper as Vgontzas et al., 2019

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Authors
Vgontzas, A. N., Li, Y., He, F., Fernandez-Mendoza, J., Gaines, J., Liao, D., Basta, M., & Bixler, E. O.
Affiliations
  • Pennsylvania State University (US)
  • Shantou University Mental Health Center (CN)
  • Sleep Research & Treatment Center, Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, PA
Corresponding author
Vgontzas, Alexandros N
ORCID
Venue
Sleep
Publisher
Oxford University Press (OUP)
Published
2018-12-22
Volume
42
Issue
4
ISSN
  • 0161-8105 (ISSN-L)
  • 1550-9109
DOI
10.1093/sleep/zsy265
PMC
PMC7182129
OpenAlex
W2905643911
Cited by
65
References
29
Citations by year
2026: 8 · 2025: 8 · 2024: 14 · 2023: 7 · 2022: 9 · 2021: 8 · 2020: 5 · 2019: 6
FWCI
3.27
Type
journal article
Language
en
Open access
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • SLEEP (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Heart, Lung, and Blood Institute (R01 HL40916, HL5193)
  • National Institutes of Health
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
obstructive sleep apnea, mild to moderate sleep apnea, hypertension incidence, age effects, metabolic syndrome, apnea-hypopnea index, young and middle-aged adults, older adults, cardiovascular risk
MeSH terms
Adult, Aged, Antihypertensive Agents, Female, Humans, Hypertension, Male, Middle Aged, Risk Factors, Cohort Studies, Prevalence, Sleep Apnea, Obstructive, Metabolic Syndrome, Young Adult

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