Mild obstructive sleep apnoea (OSA) and arterial hypertension in the EuropeanSleep Apnoea Database (ESADA) cohort study.

Abstract

Background: Mild obstructive sleep apnoea (OSA) is highly prevalent, however its association with important clinical outcomes like arterial hypertension remains unknown.

Aims and Objectives: To investigate the association between mild OSA and arterial hypertension in the European Sleep Apnoea Database (ESADA) cohort after adjusting for relevant confounding factors.

Methods: A multicentric sample of 4974 adults from the ESADA cohort who showed simple snoring or mild OSA at cardiorespiratory polygraphy was studied. We compared the predictive value of mild OSA (AHI 5-<15n/h) compared to non-apnoeic snorers on prevalent physician-diagnosed hypertension after adjustment for relevant confounding factors including gender, age, smoking, obesity, daytime sleepiness, dyslipidemia, chronic obstructive pulmonary disease and type 2 diabetes.

Results: Arterial hypertension prevalence was 37% in mild OSA patients (n=2457) compared to 20% in non-apnoeic snorers (n=2517, p<0.001). Mild OSA independently predicted prevalent hypertension after adjustment for confounders [odds ratio (95% CI) 1.43 (1.22–1.68), p<0.001]. Other independent factors associated with prevalent hypertension were waist-hip ratio [odds ratios (95% CI) 6.38 (1.85–21.98), p=0.003], type 2 diabetes [odds ratios (95% CI) 2.99 (2.29–3.91), p<0.001], and hyperlipidemia [odds ratios (95% CI) 3.08 (2.49–3.80), p<0.001].

Conclusions: Mild OSA was associated with an independent 43% risk increase for arterial hypertension in this large, multicentric clinical patient cohort.