Association of Snoring and Daytime Sleepiness With Subsequent Incident Hypertension: A Population-Based Cohort Study

医学 危险系数 四分位间距 阻塞性睡眠呼吸暂停 白天过度嗜睡 体质指数 队列 睡眠呼吸暂停 早晨 内科学 人口 艾普沃思嗜睡量表 队列研究 比例危险模型 入射(几何) 前瞻性队列研究 血压 呼吸暂停 置信区间 睡眠障碍 多导睡眠图 精神科 失眠症 物理 光学 环境卫生
作者
Pauline Balagny,Emmanuelle Vidal‐Petiot,Sofiane Kab,Justine Frija‐Masson,Philippe Gabríel Steg,Marcel Goldberg,Marie Zins,Marie‐Pia d’Ortho,Emmanuel Wiernik
出处
期刊:Hypertension [Lippincott Williams & Wilkins]
卷期号:81 (11): 2286-2297
标识
DOI:10.1161/hypertensionaha.124.23007
摘要

BACKGROUND: There is a strong association between obstructive sleep apnea and hypertension, but the effects of obstructive sleep apnea symptoms on the risk of incident hypertension are not well documented. The aim of this prospective study was to examine whether snoring and sleepiness are associated with incident hypertension. METHODS: Data from the French population-based CONSTANCES cohort were analyzed. Normotensive participants, aged 18 to 69 years, were included between 2012 and 2016 and screened for snoring, morning fatigue, and daytime sleepiness in 2017 using items of the Berlin Questionnaire. We used Cox models, adjusted for multiple potential confounders, including body mass index, baseline blood pressure, sleep duration, and depressive symptoms, to compute hazards ratios of incidentally treated hypertension. RESULTS: Among 34 727 subjects, the prevalence of self-reported habitual snoring, morning fatigue, and excessive daytime sleepiness (≥3× a week for each) was 23.6%, 16.6%, and 19.1%, respectively. During a median follow-up of 3.1 years (interquartile range, 3.0–3.5), the incidence of treated hypertension was 3.8%. The risk of de novo treated hypertension was higher in participants who reported habitual snoring (adjusted hazard ratio, 1.17 [95% CI, 1.03–1.32]) and excessive daytime sleepiness (adjusted hazard ratio, 1.42 [95% CI, 1.24–1.62]), and increased with the weekly frequency of symptoms, with a dose-dependent relationship ( P trend ≤0.02 for all symptoms). CONCLUSIONS: Self-reported snoring and excessive daytime sleepiness are associated with an increased risk of developing hypertension. Identification of snoring and daytime sleepiness may be a useful public health screening tool in primary care for hypertension prevention.
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