title: Are sleep symptoms predictors of resistant hypertension in a population-based sample? Findings from the National Health and Nutritional Examination Survey.
abstract: The aim of this study was to test the association of self-reported sleep symptoms to those identified with severe hypertension in a nationally representative sample of adults. Self-reported and study-measured health and sleep characteristics were collected by the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008. Of 10,526 individuals with completed sleep surveys participating in the study, the authors identified 379 patients with severe hypertension defined as those treated with ≥ 3 antihypertensive medications including a diuretic; 110 of these had resistant hypertension (RHTN) despite therapy, while 269 were controlled for severe hypertension (CSHTN). Patients with RHTN were more likely to be married, less educated, smoke, and self-report unsatisfactory health and diabetes when compared with patients with CSHTN. Multivariate analyses showed that poorly controlled diabetes (glycated hemoglobin >7%) was the strongest predictor of RHTN (odds ratio, 3.0; 95% confidence interval, 1.2-7.9). Unsatisfactory health (odds ratio, 1.7; 95% confidence interval, 1.7-2.7) was also associated with RHTN. Poorly controlled diabetes and self-reported unsatisfactory heath showed significant association with RHTN. Contrary to expectations, there was no significant association between self-reported snoring/snorting and RHTN, when other factors were examined. The association between poorly controlled diabetes and RHTN warrants further emphasis on strict control of diabetes in these individuals.
authors.affiliation: Department of Pulmonary, Critical Care and Sleep Medicine, University Hospitals, Case Medical Center, Cleveland, OH, USA. harneet.walia2@uhhospitals.org
authors.forename: Harneet
authors.initials: H
authors.lastname: Walia
authors.forename: Kingman
authors.initials: K
authors.lastname: Strohl
authors.forename: Brian
authors.initials: B
authors.lastname: Koo
authors.forename: Andreea
authors.initials: A
authors.lastname: Seicean
authors.forename: Sinziana
authors.initials: S
authors.lastname: Seicean
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000150:complications; D004351:Drug Resistance; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D011237:Predictive Value of Tests; D057566:Self Report; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000209:etiology*; D014481:United States
chemical_list: D000959:Antihypertensive Agents