Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 March 1994 | Volume 120 Issue 5 | Pages 382-388
Objective: To measure the independent association of sleep-disordered breathing (sleep apnea and habitual snoring) and hypertension in a healthy adult population.
Design: A cross-sectional study of blood pressure during wakefulness and sleep among participants with and without sleep-disordered breathing.
Setting: Community-based study.
Participants: 147 men and women, aged 30 to 60 years, selected from Wisconsin State employees enrolled in the Wisconsin Sleep Cohort Study, an ongoing, prospective, epidemiologic study of sleep-disordered breathing.
Measurements: Sleep and medical history interview, nocturnal polysomnography, and 24-hour ambulatory blood pressure monitoring in all participants.
Results: Mean blood pressures were significantly higher among participants with sleep apnea (
Conclusions: Our data indicate an association between hypertension and sleep apnea independent of obesity, age, and sex in a nonselected, community-based adult population.
Author and Article Information
From the University of Wisconsin School of Medicine, Madison, Wisconsin.
ARTICLE
Sleep Apnea and Hypertension: A Population-based Study
5 apneas or hypopneas per hour of sleep) compared with those without (131/80 ±1.7/1.1 mm Hg compared with 122/75 ±1.9/1.2 mm Hg during wakefulness and 113/66 ±1.8/1.1 mm Hg compared with 104/62 ±2/1.3 mm Hg during sleep, respectively; P < 0.05). The variability of the blood pressure during sleep was significantly greater in participants with sleep apnea or a history of snoring compared with those without (P < 0.05). After controlling for obesity, age, and sex, sleep apnea was significantly associated with hypertension in a dose-response fashion, with odds ratios ranging from 2.0 for 5 apneic or hypopneic episodes per hour of sleep to 5.0 for 25 apneic or hypopneic episodes.
![]()
Requests for Reprints: Khin Mae Hla, MD, MHS, Department of Medicine, University of Wisconsin, Clinical Science Center, J5/210, 600 Highland Avenue, Madison, WI, 53792.
Acknowledgments: The authors thank Claire Falk, Julie Dohr, and Ann Andre for technical assistance.
Grant Support: By National Institutes of Health grant PO1 HL 42242 and by grant RR 03186 from the Department of Veterans Affairs Medical Research Service.
Related articles in Annals:
This article has been cited by other articles:
![]() |
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al. Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) Circulation, September 2, 2008; 118(10): 1080 - 1111. [Full Text] [PDF] |
||||
![]() |
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al. Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) J. Am. Coll. Cardiol., August 19, 2008; 52(8): 686 - 717. [Full Text] [PDF] |
||||
![]() |
M D Cross, N L Mills, M Al-Abri, R Riha, M Vennelle, T W Mackay, D E Newby, and N J Douglas Continuous positive airway pressure improves vascular function in obstructive sleep apnoea/hypopnoea syndrome: a randomised controlled trial Thorax, July 1, 2008; 63(7): 578 - 583. [Abstract] [Full Text] [PDF] |
||||
![]() |
Z. T. Bloomgarden Diabetes and Obesity: Part 2 Diabetes Care, January 1, 2008; 31(1): 176 - 182. [Full Text] [PDF] |
||||
![]() |
J Amit Benjamin and K E Lewis Sleep-disordered breathing and cardiovascular disease Postgrad. Med. J., January 1, 2008; 84(987): 15 - 22. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. M. de Paula, G. Tolstykh, and S. Mifflin Chronic intermittent hypoxia alters NMDA and AMPA-evoked currents in NTS neurons receiving carotid body chemoreceptor inputs Am J Physiol Regulatory Integrative Comp Physiol, June 1, 2007; 292(6): R2259 - R2265. [Abstract] [Full Text] [PDF] |
||||
![]() |
V. A. Imadojemu, Z. Mawji, A. Kunselman, K. S. Gray, C. S. Hogeman, and U. A. Leuenberger Sympathetic Chemoreflex Responses in Obstructive Sleep Apnea and Effects of Continuous Positive Airway Pressure Therapy Chest, May 1, 2007; 131(5): 1406 - 1413. [Abstract] [Full Text] [PDF] |
||||
![]() |
W. T. McNicholas, M. R. Bonsignore, and the Management Committee of EU COST ACTION B26 Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities Eur. Respir. J., January 1, 2007; 29(1): 156 - 178. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. B. Zoccal, L. G. H. Bonagamba, F. R. T. Oliveira, J. Antunes-Rodrigues, and B. H. Machado Increased sympathetic activity in rats submitted to chronic intermittent hypoxia Exp Physiol, January 1, 2007; 92(1): 79 - 85. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. G. Zabka, G. S. Mitchell, and M. Behan Conversion from testosterone to oestradiol is required to modulate respiratory long-term facilitation in male rats J. Physiol., November 1, 2006; 576(3): 903 - 912. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. M. Rector, C. A. Richard, and R. M. Harper Cerebellar fastigial nuclei activity during blood pressure challenges J Appl Physiol, August 1, 2006; 101(2): 549 - 555. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. J. Lai, C. C. H. Yang, Y. Y. Hsu, Y. N. Lin, and T. B. J. Kuo Enhanced sympathetic outflow and decreased baroreflex sensitivity are associated with intermittent hypoxia-induced systemic hypertension in conscious rats J Appl Physiol, June 1, 2006; 100(6): 1974 - 1982. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. Norman, J. S. Loredo, R. A. Nelesen, S. Ancoli-Israel, P. J. Mills, M. G. Ziegler, and J. E. Dimsdale Effects of Continuous Positive Airway Pressure Versus Supplemental Oxygen on 24-Hour Ambulatory Blood Pressure Hypertension, May 1, 2006; 47(5): 840 - 845. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. R. A. Aoki, H. Liu, G. P. Downey, J. Mitchell, and R. L. Horner Cyclic Nucleotides Modulate Genioglossus and Hypoglossal Responses to Excitatory Inputs in Rats Am. J. Respir. Crit. Care Med., March 1, 2006; 173(5): 555 - 565. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. E. Gordon, M. S. Hughes, K. Shepherd, D. A. Szymanski, P. L. Schoenecker, L. Parker, and E. C. Uong Obstructive sleep apnoea syndrome in morbidly obese children with tibia vara J Bone Joint Surg Br, January 1, 2006; 88-B(1): 100 - 103. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Hinojosa-Laborde and S. W. Mifflin Sex Differences in Blood Pressure Response to Intermittent Hypoxia in Rats Hypertension, October 1, 2005; 46(4): 1016 - 1021. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Sakurai, T. Nishijima, S. Takahashi, K. Yamauchi, Z. Arihara, and K. Takahashi Low Plasma Orexin-A Levels Were Improved by Continuous Positive Airway Pressure Treatment in Patients With Severe Obstructive Sleep Apnea-Hypopnea Syndrome Chest, March 1, 2005; 127(3): 731 - 737. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. G Zabka, G. S Mitchell, and M Behan Ageing and gonadectomy have similar effects on hypoglossal long-term facilitation in male Fischer rats J. Physiol., March 1, 2005; 563(2): 557 - 568. [Abstract] [Full Text] [PDF] |
||||
![]() |
P Gordon and M H Sanders Sleep {middle dot} 7: Positive airway pressure therapy for obstructive sleep apnoea/hypopnoea syndrome Thorax, January 1, 2005; 60(1): 68 - 75. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. Lin, L. Finn, J. Zhang, T. Young, and E. Mignot Angiotensin-converting Enzyme, Sleep-disordered Breathing, and Hypertension Am. J. Respir. Crit. Care Med., December 15, 2004; 170(12): 1349 - 1353. [Abstract] [Full Text] [PDF] |
||||
![]() |
G V Robinson, J R Stradling, and R J O Davies Sleep {middle dot} 6: Obstructive sleep apnoea/hypopnoea syndrome and hypertension Thorax, December 1, 2004; 59(12): 1089 - 1094. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Barnes, R. D. McEvoy, S. Banks, N. Tarquinio, C. G. Murray, N. Vowles, and R. J. Pierce Efficacy of Positive Airway Pressure and Oral Appliance in Mild to Moderate Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., September 15, 2004; 170(6): 656 - 664. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. D'Ambrosio and N. S Hill A low-cost way to manage obstructive sleep apnea: does it pay? Chronic Respiratory Disease, April 1, 2004; 1(2): 89 - 91. [PDF] |
||||
![]() |
J. Heitmann, K. Ehlenz, T. Penzel, H.F. Becker, L. Grote, K.H. Voigt, J. Hermann Peter, and C. Vogelmeier Sympathetic activity is reduced by nCPAP in hypertensive obstructive sleep apnoea patients Eur. Respir. J., February 1, 2004; 23(2): 255 - 262. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. G. Zabka, G. S. Mitchell, E. B. Olson Jr, and M. Behan Selected Contribution: Chronic intermittent hypoxia enhances respiratory long-term facilitation in geriatric female rats J Appl Physiol, December 1, 2003; 95(6): 2614 - 2623. [Abstract] [Full Text] |
||||
![]() |
C. Shin, S. Joo, J. Kim, and T. Kim Prevalence and Correlates of Habitual Snoring in High School Students Chest, November 1, 2003; 124(5): 1709 - 1715. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. von Kanel and J. E. Dimsdale Hemostatic Alterations in Patients With Obstructive Sleep Apnea and the Implications for Cardiovascular Disease Chest, November 1, 2003; 124(5): 1956 - 1967. [Abstract] [Full Text] [PDF] |
||||
![]() |
V. K. Sharma, W. Galli, A. Haber, M. R. Pressman, R. Stevenson, T. J. Meyer, D. D. Peterson, J. S. Zachariah, G. Mercogliano, and L. Greenspon Unexpected Risks during Administration of Conscious Sedation: Previously Undiagnosed Obstructive Sleep Apnea Ann Intern Med, October 21, 2003; 139(8): 707 - 708. [Full Text] [PDF] |
||||
![]() |
K. L. Kwok, D. K. K. Ng, and Y. F. Cheung BP and Arterial Distensibility in Children With Primary Snoring Chest, May 1, 2003; 123(5): 1561 - 1566. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. A. Dart, J. R. Gregoire, D. D. Gutterman, and S. H. Woolf The Association of Hypertension and Secondary Cardiovascular Disease With Sleep-Disordered Breathing Chest, January 1, 2003; 123(1): 244 - 260. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. A. Massie, N. McArdle, R. W. Hart, W. W. Schmidt-Nowara, A. Lankford, D. W. Hudgel, N. Gordon, and N. J. Douglas Comparison between Automatic and Fixed Positive Airway Pressure Therapy in the Home Am. J. Respir. Crit. Care Med., January 1, 2003; 167(1): 20 - 23. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Ancoli-Israel, C. Stepnowsky, J. Dimsdale, M. Marler, M. Cohen-Zion, and S. Johnson The Effect of Race and Sleep-Disordered Breathing on Nocturnal BP "Dipping": Analysis in an Older Population Chest, October 1, 2002; 122(4): 1148 - 1155. [Abstract] [Full Text] [PDF] |
||||
![]() |
Y. Peker, J. Hedner, J. Norum, H. Kraiczi, and J. Carlson Increased Incidence of Cardiovascular Disease in Middle-aged Men with Obstructive Sleep Apnea: A 7-Year Follow-up Am. J. Respir. Crit. Care Med., July 15, 2002; 166(2): 159 - 165. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Silvestrini, B. Rizzato, F. Placidi, R. Baruffaldi, A. Bianconi, and M. Diomedi Carotid Artery Wall Thickness in Patients With Obstructive Sleep Apnea Syndrome Stroke, July 1, 2002; 33(7): 1782 - 1785. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. M. Namen, D. P. Dunagan, A. Fleischer, J. Tillett, M. Barnett, W. V. McCall, and E. F. Haponik Increased Physician-Reported Sleep Apnea* : The National Ambulatory Medical Care Survey Chest, June 1, 2002; 121(6): 1741 - 1747. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. S. Amin, T. R. Kimball, J. A. Bean, J. L. Jeffries, J. P. Willging, R. T. Cotton, S. A. Witt, B. J. Glascock, and S. R. Daniels Left Ventricular Hypertrophy and Abnormal Ventricular Geometry in Children and Adolescents with Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., May 15, 2002; 165(10): 1395 - 1399. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. A. El-Solh, M. J. Mador, P. Sikka, R. S. Dhillon, D. Amsterdam, and B. J. B. Grant Adhesion Molecules in Patients With Coronary Artery Disease and Moderate-to-Severe Obstructive Sleep Apnea* Chest, May 1, 2002; 121(5): 1541 - 1547. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. BARNES, D. HOUSTON, C. J. WORSNOP, A. M. NEILL, I. J. MYKYTYN, A. KAY, J. TRINDER, N. A. SAUNDERS, R. D. MCEVOY, and R. J. PIERCE A Randomized Controlled Trial of Continuous Positive Airway Pressure in Mild Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., March 15, 2002; 165(6): 773 - 780. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. G. Zabka, M. Behan, and G. S. Mitchell Genome and Hormones: Gender Differences in Physiology: Selected Contribution: Time-dependent hypoxic respiratory responses in female rats are influenced by age and by the estrus cycle J Appl Physiol, December 1, 2001; 91(6): 2831 - 2838. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. T. Yan, T. D. Bradley, and P. P. Liu The Role of Continuous Positive Airway Pressure in the Treatment of Congestive Heart Failure Chest, November 1, 2001; 120(5): 1675 - 1685. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. I. PACK, J. E. BLACK, J. R. L. SCHWARTZ, and J. K. MATHESON Modafinil as Adjunct Therapy for Daytime Sleepiness in Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., November 1, 2001; 164(9): 1675 - 1681. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Xie, J. B. Skatrud, D. S. Puleo, and B. J. Morgan Exposure to hypoxia produces long-lasting sympathetic activation in humans J Appl Physiol, October 1, 2001; 91(4): 1555 - 1562. [Abstract] [Full Text] [PDF] |
||||
![]() |
J R Stradling, J C T Pepperell, and R J O Davies Sleep apnoea and hypertension: proof at last? Thorax, September 1, 2001; 56(90002): ii45 - 49. [Full Text] [PDF] |
||||
![]() |
C. Guilleminault and S. N. Brooks Excessive daytime sleepiness: A challenge for the practising neurologist Brain, August 1, 2001; 124(8): 1482 - 1491. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. M. Mohan, S. Golding, and D. J. Paterson Intermittent hypoxia modulates nNOS expression and heart rate response to sympathetic nerve stimulation Am J Physiol Heart Circ Physiol, July 1, 2001; 281(1): H132 - H138. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. S. M. Ip, B. Lam, I. J. Lauder, K. W. T. Tsang, K.-f. Chung, Y.-w. Mok, and W.-k. Lam A Community Study of Sleep-Disordered Breathing in Middle-aged Chinese Men in Hong Kong Chest, January 1, 2001; 119(1): 62 - 69. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. J. MORRELL, L. FINN, H. KIM, P. E. PEPPARD, M. SAFWAN BADR, and T. YOUNG Sleep Fragmentation, Awake Blood Pressure, and Sleep-Disordered Breathing in a Population-based Study Am. J. Respir. Crit. Care Med., December 1, 2000; 162(6): 2091 - 2096. [Abstract] [Full Text] |
||||
![]() |
F McNamara and C E Sullivan Paediatric origins of adult lung diseases bullet 3: The genesis of adult sleep apnoea in childhood Thorax, November 1, 2000; 55(11): 964 - 969. [Full Text] |
||||
![]() |
E C FLETCHER Hypertension in patients with sleep apnoea, a combined effect? Thorax, September 1, 2000; 55(9): 726 - 728. [Full Text] |
||||
![]() |
C. W H Davies, J. H Crosby, R. L Mullins, C. Barbour, R. J O Davies, and J. R Stradling Case-control study of 24 hour ambulatory blood pressure in patients with obstructive sleep apnoea and normal matched control subjects Thorax, September 1, 2000; 55(9): 736 - 740. [Abstract] [Full Text] |
||||
![]() |
E. O. Bixler, A. N. Vgontzas, H.-M. Lin, T. Ten Have, B. E. Leiby, A. Vela-Bueno, and A. Kales Association of Hypertension and Sleep-Disordered Breathing Arch Intern Med, August 14, 2000; 160(15): 2289 - 2295. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. P. Blankfield, D. W. Hudgel, A. A. Tapolyai, and S. J. Zyzanski Bilateral Leg Edema, Obesity, Pulmonary Hypertension, and Obstructive Sleep Apnea Arch Intern Med, August 14, 2000; 160(15): 2357 - 2362. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. M. Samet, F. Javier Nieto, and N. M. Punjabi Sleep-disordered Breathing and Hypertension: More Research Is Still Needed Am. J. Respir. Crit. Care Med., May 1, 2000; 161(5): 1409 - 1411. [Full Text] |
||||
![]() |
J R Stradling, C Barbour, J Glennon, B A Langford, and J H Crosby Which aspects of breathing during sleep influence the overnight fall of blood pressure in a community population? Thorax, May 1, 2000; 55(5): 393 - 398. [Abstract] [Full Text] |
||||
![]() |
F. J. Nieto, T. B. Young, B. K. Lind, E. Shahar, J. M. Samet, S. Redline, R. B. D'Agostino, A. B. Newman, M. D. Lebowitz, T. G. Pickering, et al. Association of Sleep-Disordered Breathing, Sleep Apnea, and Hypertension in a Large Community-Based Study JAMA, April 12, 2000; 283(14): 1829 - 1836. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. W. Zwillich Is Untreated Sleep Apnea a Contributing Factor for Chronic Hypertension? JAMA, April 12, 2000; 283(14): 1880 - 1881. [Full Text] [PDF] |
||||
![]() |
J.-C. Vázquez, W. H Tsai, W W. Flemons, A. Masuda, R. Brant, E. Hajduk, W. A Whitelaw, and J. E Remmers Automated analysis of digital oximetry in the diagnosis of obstructive sleep apnoea Thorax, April 1, 2000; 55(4): 302 - 307. [Abstract] [Full Text] |
||||
![]() |
P. Lavie, P. Herer, and V. Hoffstein Obstructive sleep apnoea syndrome as a risk factor for hypertension: population study BMJ, February 19, 2000; 320(7233): 479 - 482. [Abstract] [Full Text] |
||||
![]() |
K. A. Franklin, P. Ake Holmgren, F. Jonsson, N. Poromaa, H. Stenlund, and E. Svanborg Snoring, Pregnancy-Induced Hypertension, and Growth Retardation of the Fetus* Chest, January 1, 2000; 117(1): 137 - 141. [Abstract] [Full Text] [PDF] |
||||