Sex differences in the association between arterial hypertension, blood pressure, and sleep apnea in the general population.
Level 4 - case-series / case-control
Cross-sectional observational study of a general population cohort
PubMed 33576736 · doi:10.5664/jcsm.9142
What was done
Home polygraphy and office blood pressure measurements were conducted in a general population cohort of 1,809 men and women. Hypertension was defined by physician diagnosis, antihypertensive medication use, or elevated blood pressure during the study visit. Rates of hypertension and blood pressure levels were analyzed across seven respiratory event index (REI) categories, adjusting for age and obesity.
What was found
Age-adjusted hypertension prevalence increased with higher REI in both sexes, but remained statistically significant only in women after adjusting for obesity. In participants not on antihypertensive medications, age-adjusted blood pressure increased with REI, reaching statistical significance even within the normal range (REI < 5 events/h). The REI threshold associated with higher blood pressure was lower in women than in men. After adjusting for obesity, the association remained significant for diastolic blood pressure but not systolic blood pressure. The abstract reported no exact numerical estimates, odds ratios, or confidence intervals.
Why it matters
The findings indicate that women may experience blood pressure elevation at lower levels of sleep-disordered breathing than men. Standard clinical thresholds for sleep apnea may underestimate cardiovascular risk in female patients.
Limits
The cross-sectional design prevents causal conclusions. Measurements relied on home polygraphy rather than in-laboratory polysomnography, and office blood pressure rather than 24-hour ambulatory monitoring. The abstract omits numerical effect sizes, variance measures, and subgroup sample sizes.
Cited by
- supports Women exhibit higher blood pressure at lower severity thresholds of sleep apnea compared to men.