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Sex differences in the association between arterial hypertension, blood pressure, and sleep apnea in the general population

Fre Bauters (UGent) , Katrien Hertegonne (UGent) , Dirk Pevernagie (UGent) , Marc De Buyzere (UGent) , Julio Chirinos Medina (UGent) and Ernst Rietzschel (UGent)
(2021) JOURNAL OF CLINICAL SLEEP MEDICINE. 17(5). p.1057-1066
Author
Organization
Abstract
Study Objectives: To assess sex-related differences in the relationship between hypertension (HT), blood pressure (BP), and sleep apnea in the general population. Methods: We performed home polygraphy in a cohort of 1809 men and women in the general population. Office BP was measured. Presence of HT (drug-treated, physician-diagnosed, or high BP during study visit) was also recorded. HT rate and BP were assessed over a range of 7 sleep apnea severity categories based on the respiratory event index (REI). Results: The age-adjusted HT prevalence rate increased with higher REI in both sexes. After additional adjustment for obesity the association remained significant in women but not in men. In participants not treated with antihypertensive medications, age-adjusted BP increased with REI. Remarkably, the association was already significant within the normal range (REI <5 events/h). The REI threshold for higher BP was situated at a distinctly lower cutoff point in women compared to men. After additional adjustment for obesity, the associations remained significant for diastolic but not systolic BP. Conclusions: Significant increases in the age-adjusted BP and HT rate in the general population were present at lower REI cutoffs in women compared to men. Even a very low number of respiratory events was associated with higher BP and HT prevalence. Adjustment for obesity attenuated these associations, especially in men. Sex differences in BP susceptibility across the sleep apnea spectrum may be present.
Keywords
GENDER-DIFFERENCES, RISK-FACTOR, PREVALENCE, SEVERITY, HYPOPNEA, IMPACT, OSA, AGE, sleep apnea, hypertension, blood pressure, sleep-disordered breathing, cohort study

Citation

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MLA
Bauters, Fre, et al. “Sex Differences in the Association between Arterial Hypertension, Blood Pressure, and Sleep Apnea in the General Population.” JOURNAL OF CLINICAL SLEEP MEDICINE, vol. 17, no. 5, 2021, pp. 1057–66, doi:10.5664/jcsm.9142.
APA
Bauters, F., Hertegonne, K., Pevernagie, D., De Buyzere, M., Chirinos Medina, J., & Rietzschel, E. (2021). Sex differences in the association between arterial hypertension, blood pressure, and sleep apnea in the general population. JOURNAL OF CLINICAL SLEEP MEDICINE, 17(5), 1057–1066. https://doi.org/10.5664/jcsm.9142
Chicago author-date
Bauters, Fre, Katrien Hertegonne, Dirk Pevernagie, Marc De Buyzere, Julio Chirinos Medina, and Ernst Rietzschel. 2021. “Sex Differences in the Association between Arterial Hypertension, Blood Pressure, and Sleep Apnea in the General Population.” JOURNAL OF CLINICAL SLEEP MEDICINE 17 (5): 1057–66. https://doi.org/10.5664/jcsm.9142.
Chicago author-date (all authors)
Bauters, Fre, Katrien Hertegonne, Dirk Pevernagie, Marc De Buyzere, Julio Chirinos Medina, and Ernst Rietzschel. 2021. “Sex Differences in the Association between Arterial Hypertension, Blood Pressure, and Sleep Apnea in the General Population.” JOURNAL OF CLINICAL SLEEP MEDICINE 17 (5): 1057–1066. doi:10.5664/jcsm.9142.
Vancouver
1.
Bauters F, Hertegonne K, Pevernagie D, De Buyzere M, Chirinos Medina J, Rietzschel E. Sex differences in the association between arterial hypertension, blood pressure, and sleep apnea in the general population. JOURNAL OF CLINICAL SLEEP MEDICINE. 2021;17(5):1057–66.
IEEE
[1]
F. Bauters, K. Hertegonne, D. Pevernagie, M. De Buyzere, J. Chirinos Medina, and E. Rietzschel, “Sex differences in the association between arterial hypertension, blood pressure, and sleep apnea in the general population,” JOURNAL OF CLINICAL SLEEP MEDICINE, vol. 17, no. 5, pp. 1057–1066, 2021.
@article{8744818,
  abstract     = {{Study Objectives: To assess sex-related differences in the relationship between hypertension (HT), blood pressure (BP), and sleep apnea in the general population. Methods: We performed home polygraphy in a cohort of 1809 men and women in the general population. Office BP was measured. Presence of HT (drug-treated, physician-diagnosed, or high BP during study visit) was also recorded. HT rate and BP were assessed over a range of 7 sleep apnea severity categories based on the respiratory event index (REI). Results: The age-adjusted HT prevalence rate increased with higher REI in both sexes. After additional adjustment for obesity the association remained significant in women but not in men. In participants not treated with antihypertensive medications, age-adjusted BP increased with REI. Remarkably, the association was already significant within the normal range (REI <5 events/h). The REI threshold for higher BP was situated at a distinctly lower cutoff point in women compared to men. After additional adjustment for obesity, the associations remained significant for diastolic but not systolic BP. Conclusions: Significant increases in the age-adjusted BP and HT rate in the general population were present at lower REI cutoffs in women compared to men. Even a very low number of respiratory events was associated with higher BP and HT prevalence. Adjustment for obesity attenuated these associations, especially in men. Sex differences in BP susceptibility across the sleep apnea spectrum may be present.}},
  author       = {{Bauters, Fre and Hertegonne, Katrien and Pevernagie, Dirk and De Buyzere, Marc and Chirinos Medina, Julio and Rietzschel, Ernst}},
  issn         = {{1550-9389}},
  journal      = {{JOURNAL OF CLINICAL SLEEP MEDICINE}},
  keywords     = {{GENDER-DIFFERENCES,RISK-FACTOR,PREVALENCE,SEVERITY,HYPOPNEA,IMPACT,OSA,AGE,sleep apnea,hypertension,blood pressure,sleep-disordered breathing,cohort study}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{1057--1066}},
  title        = {{Sex differences in the association between arterial hypertension, blood pressure, and sleep apnea in the general population}},
  url          = {{http://doi.org/10.5664/jcsm.9142}},
  volume       = {{17}},
  year         = {{2021}},
}
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