Abstract
This study investigated differences in sleep-disordered breathing (SDB) between hypertensives without a family history of hypertension and hypertensives with a family history. Furthermore, it examined whether these two groups differed in the severity of SDB. Patients were African Americans (n=162, mean age=51.19±13.77 years; mean body mass index (BMI)=37.85±9.51 kg/m2, male=57%), who were referred to the clinic because of a sleep complaint. Sleep was recorded in the laboratory using standard physiological parameters; all parameters were analysed by a trained scorer. Altogether, 91% of the patients received an SDB diagnosis. Of these patients, 25% were hypertensives without a family history, 20% were hypertensives with a family history, and 55% were normotensives. We found a significant difference between these patient groups regarding the severity of SDB (F14,158=1.823, P<0.05), but no significant group difference was observed in the rate of SDB. Increasing weight was accompanied by increasing severity of SDB. The finding that hypertensive patients with or without a positive family history showed worse oxygenation and respiratory characteristics than did normotensives is consistent with previous research. Of note, hypertensives reporting a family history were characterized by a greater number of oxygen desaturations and apnoea hypopnoea index than those typified only by a current diagnosis of hypertension. Hypertensives with a family history are likely to show a profile of greater blood pressure, higher BMI, and more severe SDB, which by all accounts are more common among African Americans.
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References
Young T, Finn L . Epidemiological insights into the public health burden of sleep disordered breathing: sex differences in survival among sleep clinic patients. Thorax 1998; 53(Suppl 3): S16–S19.
Phillipson EA . Sleep apnea – a major public health problem. N Engl J Med 1993; 328: 1271–1273.
Redline S et al. Racial differences in sleep-disordered breathing in African-Americans and Caucasians. Am J Respir Crit Care Med 1997; 155: 186–192.
Kripke DF et al. Prevalence of sleep disordered breathing in ages 40–64 years: a population-based survey. Sleep 1997; 20: 65–76.
Ancoli-Israel S et al. Sleep-disordered breathing in African-American elderly. Am J Respir Crit Care Med 1995; 152: 1946–1949.
Casimir G et al. Sleep-disordered breathing in a predominantly minority sample. Sleep 2002; 25: 339–340.
Gottlieb DJ et al. Relation of sleepiness to respiratory disturbance index: the Sleep Heart Health Study. Am J Respir Crit Care Med 1999; 159: 502–507.
(2002) The National Commission on Sleep Disorders Research. Wake up America: A National Sleep Alert. US Government Printing Office: Washington DC, 1993.
Rosen RC, Zozula R, Jahn EG, Carson JL . Low rates of recognition of sleep disorders in primary care: comparison of a community-based versus clinical academic setting. Sleep Med 2001; 2: 47–55.
Penn NE et al. Ethnic minorities, health care systems, and behavior. Health Psychol 1995; 14: 641–646.
Mayberry RM, Mili F, Ofili E . Racial and ethnic differences in access to medical care. Med Care Res Rev 2000; 57(Suppl 1): 108–145.
Wright J et al. Health effects of obstructive sleep apnoea and the effectiveness of continuous positive airways pressure: a systematic review of the research evidence. BMJ 1997; 314: 851–860.
Silverberg DS, Oksenberg A, Iaina A . Sleep-related breathing disorders as a major cause of essential hypertension: fact or fiction? Curr Opin Nephrol Hypertens 1998; 7: 353–357.
Harding SM . Complications and consequences of obstructive sleep apnea. Curr Opin Pulm Med 2000; 6: 485–489.
Lavie P et al. Mortality in sleep apnea patients: a multivariate analysis of risk factors. Sleep 1995; 18: 149–157.
Lavie P, Herer P, Hoffstein V . Obstructive sleep apnoea syndrome as a risk factor for hypertension: population study. BMJ 2000; 320: 479–482.
Ohayon MM et al. Is sleep-disordered breathing an independent risk factor for hypertension in the general population (13,057 subjects)? J Psychosom Res 2000; 48: 593–601.
Young T et al. Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch Intern Med 1997; 157: 1746–1752.
Phillips BG, Somers VK . Hypertension and obstructive sleep apnea. Curr Hypertens Rep 2003; 5: 380–385.
Wolk R, Shamsuzzaman AS, Somers VK . Obesity, sleep apnea, and hypertension. Hypertension 2003; 42: 1067–1074.
Loredo JS et al. Obstructive sleep apnea and hypertension: are peripheral chemoreceptors involved? Med Hypotheses 2001; 56: 17–19.
Kawabe H, Saito I, Nagano S, Saruta T . Relation of home blood pressure to body weight in young normotensive men with or without family history of hypertension. Am J Hypertens 1994; 7: 498–502.
Czarkowski M, Chojnowski K, Osikowska-Loksztejn M, Chodakowska J . Blood pressure in young men with a family history of primary hypertension – traditional and 24-hour blood pressure measurements. Pol Tyg Lek 1994; 49: 221–224.
Balwierz P, Grzeszczak W . Influence of family history of hypertension on blood pressure in young healthy men. Pol Arch Med Wewn 2003; 109: 7–14.
Ibsen KK . Blood-pressures in offspring of hypertensive parents. Acta Paediatr Scand 1984; 73: 842–847.
Narkiewicz K et al. Relation between family history of hypertension, overweight and ambulatory blood pressure: the HARVEST study. J Hum Hypertens 1995; 9: 527–533.
Chesson Jr AL et al. The indications for polysomnography and related procedures. Sleep 1997; 20: 423–487.
Rechtshaffen A, Kales A . A Manual of Standardized Terminology, Techniques, and Scoring Systems of Sleep Stages of Human Subjects. UCLA Brain Information Service/Brain Research Institute: Los Angeles, 10, 1968.
Bonnet MH et al. EEG arousals: scoring rules and examples: a preliminary report from The Sleep Disorders Atlas Task Force of The American Sleep Disorders Association. Sleep 1992; 15: 173–184.
Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999; 22: 667–689.
Lackland DT, Lin Y, Tilley BC, Egan BM . An assessment of racial differences in clinical practices for hypertension at primary care sites for medically underserved patients. J Clin Hypertens (Greenwich) 2004; 6: 26–31.
Stoohs RA et al. Sleep-disordered breathing and systemic hypertension in the older male. J Am Geriatr Soc 1996; 44: 1295–1300.
Ogedegbe G et al. Barriers and facilitators of medication adherence in hypertensive African Americans: a qualitative study. Ethn Dis 2004; 14: 3–12.
Daniels PR et al. Familial aggregation of hypertension treatment and control in the Genetic Epidemiology Network of Arteriopathy (GENOA) study. Am J Med 2004; 116: 676–681.
Ashaye MO, Giles WH . Hypertension in Blacks: a literature review. Ethn Dis 2003; 13: 456–462.
Gulliford MC, Mahabir D, Rocke B . Socioeconomic inequality in blood pressure and its determinants: cross-sectional data from Trinidad and Tobago. J Hum Hypertens 2004; 18: 61–70.
Ogedegbe G, Mancuso CA, Allegrante JP . Expectations of blood pressure management in hypertensive African-American patients: a qualitative study. J Natl Med Assoc 2004; 96: 442–449.
Lukoschek P . African Americans' beliefs and attitudes regarding hypertension and its treatment: a qualitative study. J Health Care Poor Underserved 2003; 14: 566–587.
Naughton MT . Sleep disorders in patients with congestive heart failure. Curr Opin Pulm Med 2003; 9: 453–458.
Kaneko Y et al. Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. N Engl J Med 2003; 348: 1233–1241.
Sjostrom C et al. Prevalence of sleep apnoea and snoring in hypertensive men: a population based study. Thorax 2002; 57: 602–607.
Buxbaum SG, Elston RC, Tishler PV, Redline S . Genetics of the apnea hypopnea index in Caucasians and African Americans: I. Segregation analysis. Genet Epidemiol 2002; 22: 243–253.
Colilla S et al. Genetic inheritance of body mass index in African-American and African families. Genet Epidemiol 2000; 18: 360–376.
Palmer LJ et al. A whole-genome scan for obstructive sleep apnea and obesity. Am J Hum Genet 2003; 72: 340–350.
Palmer LJ et al. Whole genome scan for obstructive sleep apnea and obesity in African-American families. Am J Respir Crit Care Med 2004; 169: 1314–1321.
Nath SK et al. Segregation analysis of blood pressure and body mass index in a rural US community. Hum Biol 2002; 74: 11–23.
Cui J, Hopper JL, Harrap SB . Genes and family environment explain correlations between blood pressure and body mass index. Hypertension 2002; 40: 7–12.
Palmer LJ, Redline S . Genomic approaches to understanding obstructive sleep apnea. Respir Physiol Neurobiol 2003; 135: 187–205.
Gaultier C, Guilleminault C . Genetics, control of breathing, and sleep-disordered breathing: a review. Sleep Med 2001; 2: 281–295.
Acknowledgements
This research was supported by NIA (AG12364-07S1). We thank Kant Beaugris, Lisa Bobb, and Barbara Rodriguez for their assistance in the study.
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Jean-Louis, G., Zizi, F., Casimir, G. et al. Sleep-disordered breathing and hypertension among African Americans. J Hum Hypertens 19, 485–490 (2005). https://doi.org/10.1038/sj.jhh.1001855
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DOI: https://doi.org/10.1038/sj.jhh.1001855
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