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.
This is a preview of subscription content, access via your institution
Open Access articles citing this article.
BMC Women's Health Open Access 29 January 2007
Subscribe to Journal
Get full journal access for 1 year
only $9.92 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Get time limited or full article access on ReadCube.
All prices are NET prices.
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.
This research was supported by NIA (AG12364-07S1). We thank Kant Beaugris, Lisa Bobb, and Barbara Rodriguez for their assistance in the study.
About this article
Cite this article
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
- sleep-disordered breathing
This article is cited by
BMC Women's Health (2007)
Current Cardiology Reports (2005)