Am. J. Respir. Crit. Care Med., Volume 160, Number 6, December 1999, 1875-1882

Sleep-related Breathing Disorder Is an Independent Risk Factor for Systemic Hypertension

LUDGER GROTE, THOMAS PLOCH, JÖRG HEITMANN, LENNART KNAACK, THOMAS PENZEL, and JÖRG HERMANN PETER

Schlafmedizinisches Labor, Medizinische Poliklinik, Universität Marburg, Marburg, Germany; and Department of Clinical Pharmacology, Sahlgrenska University Hospital, Gothenburg, Sweden

The exact influence of sleep-related breathing disorder (SRBD) on blood pressure control remains unknown. We investigated the influence of different degrees of SRBD on daytime blood pressure and its association to documented hypertension by examining 1,190 consecutive patients referred for diagnosis of SRBD. The protocol includes clinical interview, physical examination, office blood pressure measurement, cholesterol, and blood gas analysis. Unattended home monitoring of nocturnal breathing was performed for assessment of SRBD activity (respiratory disturbance index [RDI]). RDI was independently and linearly associated with systolic blood pressure (unstandardized coefficient [B] = 0.07 ± 0.03, p = 0.03), diastolic blood pressure (B = 0.07 ± 0.02, p = 0 < 0.001), and heart rate (B = 0.10 ± 0.02, p < 0.001) at rest. The relative risk for hypertension (blood pressure  160/95 mm Hg) increased with SRBD severity (odds ratio [OR], 4.15 for RDI  40 versus < 5 [95% CI, 2.7 to 6.5]). This relative risk was also elevated in younger ( 50 yr) compared with older patients (> 50 yr) (OR, 7.15 versus 2.70 for RDI  40 versus < 5). These cross-sectional clinical data suggest a relationship between SRBD severity and systolic blood pressure, diastolic blood pressure, and heart rate after control for confounders such as body mass index (BMI), age, alcohol/nicotine consumption, cholesterol level, and daytime PO₂ and PCO₂. SRBD is an independent risk factor for systemic hypertension with an increased likelihood in subjects  50 yr of age. Grote L, Ploch T, Heitmann J, Knaack L, Penzel T, Peter JH. Sleep-related breathing disorder is an independent risk factor for systemic hypertension.

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