Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Mild-to-Moderate OSA Linked with Hypertension

Sleep; ePub 2018 Dec 22; Vgontzas, et al

Mild-to-moderate obstructive sleep apnea (OSA), even when asymptomatic, is associated with increased risk of incident hypertension, but the strength of association significantly decreases with age, according to a recent study. Therefore, although older subjects with asymptomatic mild-to-moderate OSA are not at significant risk of developing hypertension, early detection and intervention, including improving metabolic indices, is especially warranted in young and middle-aged adults. From 1,741 adults of the Penn State Cohort, 744 adults without hypertension or severe OSA [ie, apnea/hypopnea index (AHI) ≥ 30 events/hour] were followed-up after 9.2 years. Mild OSA was defined as an AHI of 5 to 14.9 events/hour (n=71), while moderate OSA as an AHI of 15 to 29.9 events/hour (n=32). Researchers found:

  • After adjusting for multiple potential confounders, mild-to-moderate OSA was significantly associated with increased risk of incident hypertension.
  • Importantly, this association was modified by age; while strong in young and middle-aged adults, the association was lost in adults >60 years.
  • Furthermore, the association of mild-to-moderate OSA with components of metabolic syndrome was strongest in young and middle-aged adults.

Vgontzas AM, Li Y, He F, et al. Mild-to-moderate sleep apnea is associated with incident hypertension: Age effect. [Published online ahead of print December 22, 2018]. Sleep. doi:10.1093/sleep/zsy265.