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Titolo:
Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study
Autore:
Nieto, FJ; Young, TB; Lind, BK; Shahar, E; Samet, JM; Redline, S; DAgostino, RB; Newman, AB; Lebowitz, MD; Pickering, TG;
Indirizzi:
Johns Hopkins Univ, Johns Hopkins Sch Hyg & Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA Johns Hopkins Univ Baltimore MD USA 21205 demiol, Baltimore, MD 21205 USA Univ Wisconsin, Madison, WI USA Univ Wisconsin Madison WI USAUniv Wisconsin, Madison, WI USA Univ Minnesota, Minneapolis, MN USA Univ Minnesota Minneapolis MN USAUniv Minnesota, Minneapolis, MN USA Univ Hosp Cleveland, Rainbow Babies & Childrens Hosp, Div Clin Epidemiol, Cleveland, OH 44106 USA Univ Hosp Cleveland Cleveland OH USA 44106 emiol, Cleveland, OH 44106 USA Boston Univ, Dept Math, Boston, MA 02215 USA Boston Univ Boston MA USA 02215 ton Univ, Dept Math, Boston, MA 02215 USA Univ Pittsburgh, Sch Med, Div Geriatr Med, Pittsburgh, PA USA Univ Pittsburgh Pittsburgh PA USA d, Div Geriatr Med, Pittsburgh, PA USA Univ Arizona, Coll Med, Resp Sci Ctr, Tucson, AZ USA Univ Arizona Tucson AZ USA izona, Coll Med, Resp Sci Ctr, Tucson, AZ USA Cornell Univ, New York Cornell Med Ctr, Ctr Cardiovasc, New York, NY USA Cornell Univ New York NY USA l Med Ctr, Ctr Cardiovasc, New York, NY USA
Titolo Testata:
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
fascicolo: 14, volume: 283, anno: 2000,
pagine: 1829 - 1836
SICI:
0098-7484(20000412)283:14<1829:AOSBSA>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSITIVE AIRWAY PRESSURE; BLOOD-PRESSURE; SYSTEMIC HYPERTENSION; RISK-FACTORS; RELATIVE RISK; PREVALENCE; POPULATION; MORTALITY; HEALTH; MEN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
54
Recensione:
Indirizzi per estratti:
Indirizzo: Nieto, FJ Johns Hopkins Univ, Johns Hopkins Sch Hyg & Publ Hlth, Dept Epidemiol, 615N Wolfe St,Room W6009, Baltimore, MD 21205 USA Johns Hopkins Univ615 N Wolfe St,Room W6009 Baltimore MD USA 21205
Citazione:
F.J. Nieto et al., "Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study", J AM MED A, 283(14), 2000, pp. 1829-1836

Abstract

Context Sleep-disordered breathing (SDB) and sleep apnea have been linked to hypertension in previous studies, but most of these studies used surrogate information to define SDB (eg, snoring) and were based on small clinic populations, or both. Objective To assess the association between SDB and hypertension in a large cohort of middle-aged and older persons. Design and Setting Cross-sectional analyses of participants in the Sleep Heart Health Study, a community-based multicenter study conducted between November 1995 and January 1998. Participants A total of 6132 subjects recruited from ongoing population-based studies (aged greater than or equal to 40 years; 52.8% female). Main Outcome Measures Apnea-hypopnea index (AHI, the average number of apneas plus hypopneas per hour of sleep, with hypopnea defined as a greater than or equal to 30% reduction in airflow or thoracoabdominal excursion accompanied by a greater than or equal to 4% drop in oxyhemoglobin saturation), obtained by unattended home polysomnography. Other measures include arousalindex; percentage of sleep time below 90% oxygen saturation; history of snoring; and presence of hypertension, defined as resting blood pressure of at least 140/90 mm Hg or use of antihypertensive medication. Results Mean systolic and diastolic blood pressure and prevalence of hypertension increased significantly with increasing SDB measures, although someof this association was explained by body mass index (BMI). After adjusting for demographics and anthropometric variables (including BMI, neck circumference, and waist-to-hip ratio), as well as for alcohol intake and smoking, the odds ratio for hypertension, comparing the highest category of AHI (greater than or equal to 30 per hour) with the lowest category (<1.5 per hour), was 1.37 (95% confidence interval [CI], 1.03-1.83; P for trend=.005). The corresponding estimate comparing the highest and lowest categories of percentage of sleep time below 90% oxygen saturation (greater than or equal to 12% vs <0.05%) was 1.46 (95% CI, 1.12-1.88; P for trend <.001). In stratified analyses, associations of hypertension with either measure of SDB wereseen in both sexes, older and younger ages, all ethnic groups, and among normal-weight and overweight individuals. Weaker and nonsignificant associations were observed for the arousal index or self-reported history of habitual snoring. Conclusion Our findings from the largest cross-sectional study to date indicate that SDB is associated with systemic hypertension in middle-aged and older individuals of different sexes and ethnic backgrounds.

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Documento generato il 30/11/20 alle ore 16:35:52