Systemic Hypertension and Risk of Obstructive Sleep Apnea Syndrome: a Case- Control Study in Yerevan, Armenia

Abstract

ABSTRACT: Introduction: Systemic hypertension (HTN) and obstructive sleep apnea syndrome (OSAS) are common conditions affecting middle-aged and elderly adults, and both conditions are associated with significant morbidity and mortality. HTN is very prevalent in Armenia. OSAS has been recognized in the Western world as a public health burden, but there have been no OSAS related epidemiological studies conducted in Armenia. Objective: To measure the independent association between risk of OSAS and systemic HTN in adult people living in Yerevan considering all known confounders. Methods: The study utilized a case-control design. The main outcome measure was the HTN status; the independent variable was the risk of OSAS. The study population (108 cases and 157 unmatched controls) came from the sample population (170 hypertensives and 578 normotensives) of Hypertension Extended Study in Armenia (HESA) conducted in 2004 by the Armenian Medical Association in Yerevan. The study utilized questionnaires and measurements of blood pressure and body habitus. The study measured the OSAS risk through the Berlin Questionnaire. Data analysis was performed using SPSS and STATA software. Results: The odds of HTN in people with high risk of OSAS was 2.17 times greater (95% CI: 1.02, 4.63) than odds of HTN in people with low risk of OSAS after adjusting for age, neck circumference and co-morbidities (diabetes and/or renal disease). Conclusions: This case-control study found an independent positive association between OSAS risk and HTN. The study identified fat deposition in the neck as an influential determinant of HTN and OSAS risk, and indicated that development of diabetes and renal disease were important risk factors for HTN. It also showed that the risk of developing HTN increases with age.