title: Comparisons of sleep apnoea rate and outcomes among patients with resistant and non-resistant hypertension.
abstract: We directly compared sleep apnoea (SA) rates and risk of cardiovascular and mortality outcomes among SA patients with resistant hypertension (RH) and non-RH within a large diverse hypertension population.
  
  
  
  A retrospective cohort study between 1 January 2006 and 31 December 2010 among hypertensive adults (age ≥ 18 years) was performed within an integrated health system. Rates of SA in RH and non-RH were determined. Multivariable logistic regression analyses were used to calculate OR for SA. Cox proportional hazard modelling was used to estimate hazard ratios (HRs) for cardiovascular and mortality outcomes between SA in RH versus SA in non-RH adjusting for age, gender, race, BMI, chronic kidney disease and other comorbidities.
  
  
  
  SA was identified in 33 682 (7.2%) from 470 386 hypertensive individuals. SA in RH accounted for 5806 (9.6%) compared to SA in non-RH 27 876 individuals (6.8%). Multivariable OR (95% CI) for SA was 1.16 (1.12, 1.19), 3.57 (3.47, 3.66) and 2.20 (2.15, 2.25) for RH versus non-RH, BMI ≥ 30, and males, respectively. Compared to SA in non-RH individuals, SA in RH had a multivariable adjusted HR (95% CI) of 1.24 (1.13, 1.36), 1.43 (1.28, 1.61), 0.98 (0.85, 1.12) and 1.04 (0.95, 1.14) for ischaemic heart event (IHE), congestive heart failure (CHF), stroke and mortality, respectively.
  
  
  
  We observed a modest increase in likelihood for SA among RH compared to non-RH patients. Risks for IHE and CHF were higher for SA in RH compared to SA in non-RH patients; however, there were no differences in risk for stroke and mortality.
authors.affiliation: Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA. simran.x.bhandari@kp.org.
authors.forename: Simran K
authors.initials: SK
authors.lastname: Bhandari
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA.
authors.forename: Jiaxiao
authors.initials: J
authors.lastname: Shi
authors.affiliation: Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
authors.forename: Miklos Z
authors.initials: MZ
authors.lastname: Molnar
authors.affiliation: Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Rasgon
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA.
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Derose
authors.affiliation: Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
authors.forename: Csaba P
authors.initials: CP
authors.lastname: Kovesdy
authors.affiliation: Department of Cardiovascular Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Calhoun
authors.affiliation: Division of Nephrology and Hypertension, University of California Irvine Medical Center, Irvine, California, USA.
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
authors.affiliation: Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA.
authors.forename: John J
authors.initials: JJ
authors.lastname: Sim
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003329:Coronary Vasospasm / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology*; D017063:Outcome Assessment, Health Care; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology; D013223:Statistics as Topic; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology
keywords: epidemiology; outcomes; resistant hypertension; sleep apnoea