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Yonsei Med J. 2015 Sep;56(5):1258-65. doi: 10.3349/ymj.2015.56.5.1258.

Clinical Features of Obstructive Sleep Apnea That Determine Its High Prevalence in Resistant Hypertension.

Author information

1
Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
2
Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
3
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
4
The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Korea.
5
Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea.
6
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea. shpark0530@yuhs.ac.
7
Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. hyungjucho@yuhs.ac.

Abstract

PURPOSE:

Resistant hypertension (HTN) occurs in 15-20% of treated hypertensive patients, and 70-80% of resistant hypertensive patients have obstructive sleep apnea (OSA). The characteristics of resistant HTN that predispose patients to OSA have not been reported. Therefore, we aimed to determine the clinical, laboratory, and polysomnographic features of resistant HTN that are significantly associated with OSA.

MATERIALS AND METHODS:

Hypertensive patients (n=475) who underwent portable polysomnography were enrolled. The patients were categorized into controlled (n=410) and resistant HTN (n=65) groups. The risk factors for the occurrence of OSA in controlled and resistant hypertensive patients were compared, and independent risk factors that are associated with OSA were analyzed.

RESULTS:

Out of 475 patients, 359 (75.6%) were diagnosed with OSA. The prevalence of OSA in resistant HTN was 87.7%, which was significantly higher than that in controlled HTN (73.7%). Age, body mass index, neck circumference, waist circumference, and hip circumference were significantly higher in OSA. However, stepwise multivariate analyses revealed that resistant HTN was not an independent risk factor of OSA.

CONCLUSION:

The higher prevalence and severity of OSA in resistant HTN may be due to the association of risk factors that are common to both conditions.

KEYWORDS:

Resistant hypertension; body mass index; obesity; polysomnography; sleep apnea

PMID:
26256968
PMCID:
PMC4541655
DOI:
10.3349/ymj.2015.56.5.1258
[Indexed for MEDLINE]
Free PMC Article

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