Association of Obstructive Sleep Apnea with Nighttime Blood Pressure in African Americans: the Jackson Heart Study.
BACKGROUND:Obstructive sleep apnea (OSA), nocturnal hypertension, and non-dipping systolic blood pressure (BP) are each highly prevalent among African Americans. However, few data are available on the association between OSA and nighttime BP in this population. METHODS:We examined the association of OSA with nighttime BP among African Americans who completed 24-hour ambulatory BP monitoring at Exam 1 (2000-2004) of the Jackson Heart Study (JHS) and subsequently participated in the JHS Sleep Study (2012-2016). Type 3 home sleep apnea testing was used to assess OSA measures, including respiratory event index (REI4%) and percent sleep time <90% oxygen saturation (nocturnal hypoxemia). Nocturnal hypertension was defined as mean asleep SBP ≥120 mm Hg or DBP ≥70 mm Hg. Multivariable linear regression models were fit to estimate the association between each OSA measure and nighttime systolic BP (SBP) and diastolic BP (DBP). RESULTS:Among 206 participants who completed ABPM and participated in the Jackson Heart Sleep Study, 50.5% had nocturnal hypertension and 26.2% had moderate to severe OSA (REI4% ≥15 events/hour). After multivariable adjustment, each standard deviation (SD: 13.3 events/hour) increase in REI4% was associated with 1.75 mm Hg higher nighttime DBP (95% confidence interval [CI]: 0.38, 3.11) and a prevalence ratio of 1.11 (95% CI: 1.00, 1.24) for nocturnal hypertension. Each SD (10.4%) increase in nocturnal hypoxemia was associated with a 1.91 mm Hg higher nighttime SBP (95% CI: 0.15, 3.66). CONCLUSIONS:Severity of OSA and nocturnal hypoxemia were associated with high nighttime BP in African American participants in the JHS.
Thomas, SJ; Johnson, DA; Guo, N; Abdalla, M; Booth, JN; Spruill, TM; Jackson, CL; Yano, Y; Sims, M; Calhoun, D; Muntner, P; Redline, S
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