P3006Association of obstructive sleep apnoea and short sleep duration with hypertension: the Brazilian longitudinal study of adult health ( (ELSA-Brasil)

Abstract

Background: Independent studies suggested that obstructive sleep apnoea (OSA) and subjective short sleep duration (SSD) are associated with hypertension. However, it is not clear whether this association is true considering objective measurements of sleep duration as well as if the co-morbid OSA and SSD were independently associated with hypertension compared to each sleep disturbance. Purpose(s): To compare the prevalence of hypertension and blood pressure (BP) levels in patients with no sleep disturbances (OSA-SSD-), patients with OSA (OSA+SSD-), patients with SSD (OSA-SSD+) and both (OSA+SSD+) in the ELSA-Brazil cohort. Method(s): Participants from both genders performed portable sleep monitoring (Embletta GoldTM) for one night and pulse actigraphy for one week. OSA was defined by an apnoea-hypopnoea index >=15 events per hour. SSD was defined by a mean sleep duration <6 hours. Resting blood pressure was measured 3 times in the seated position after 5 minutes rest. The average of the second and third measurements were used in the analyses. Hypertension was defined by a BP >=140x90mmHg or previous use of anti-hypertensive medication. Result(s): We studied 1372 participants (age: 49+/-8 years, males 44% and body mass index, BMI 27.1+/-4.7kg/m2). The frequency of OSA and SSD were 455 participants (33.2%) and SSD was 392 participants (27.3%), respectively. Hypertension was diagnosed in 366 participants (26.7%). Compared with OSASSD-, OSA and OSA+SSD+ groups had highest levels of systolic BP (115+/-14; 124+/-16 and 122+/-16mmHg, respectively; p<0.001), diastolic BP (73+/-9; 79+/-11 and 80+/-11mmHg, respectively; p<0.001) and the hypertension diagnosis (18.9%; 40.2% e 40.3%, respectively; p<0.05). No significant differences were observed in the OSA-SSD+ group. The combination of OSA and SSD was not associated with higher levels of BP and prevalent hypertension. In the multivariate analysis adjusted for age, gender, BMI and use of anti-hypertensive medication, the presence of OSA was independently associated with the diastolic BP (beta=1.18, IC 95%=0.04-2.33), but not to the systolic BP neither the hypertension diagnosis. Conclusion(s): Our preliminary findings suggest that OSA, but not SSD, was independently associated with higher values of diastolic BP in an adult cohort.