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The relationship of hypertension with obesity and obstructive sleep apnea in adolescents
Author(s) -
Khan Masrur A.,
Mathur Kanika,
Barraza Giselle,
Sin Sanghun,
Yang Christina J.,
Arens Raanan,
Sutton Nicole,
Mahgerefteh Joseph
Publication year - 2020
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24693
Subject(s) - medicine , obstructive sleep apnea , body mass index , blood pressure , polysomnography , obesity , apnea–hypopnea index , sleep apnea , apnea , cardiology , cohort , hypopnea , physical therapy
Objectives To assess the independent relationships of obesity and obstructive sleep apnea (OSA) with hypertension/elevated blood pressure (EBP) in adolescent patients. Study Design A retrospective cohort analysis was performed on 501 patients (age 13‐21 years) with three separate blood pressure measurements within 6 months of polysomnography. EBP was defined as average systolic blood pressure (SBP) ≤120 mm Hg; obesity as body mass index Z ‐score ≤1.65; and OSA as obstructive apnea‐hypopnea index <1. Pearson correlations and multivariable analyses were performed to assess the independent effects of the apnea‐hypopnea index and body mass index Z ‐score on SBP. Results Of 501 patients (mean age 16 ± 2 years), 246 (49%) were male. OSA was present in 329 (66%) patients, obesity in 337 (67%), and EBP in 262 (52%). EBP was present in 70% of obese adolescents and 60% of adolescents with OSA. Univariable correlation showed a significant relationship between SBP, body mass index Z ‐score, and apnea‐hypopnea index. Multivariable linear regression analysis showed blood pressure was significantly associated with body mass index Z ‐score ( β = .46; P < .01), age ( β = .25; P < .01), and height Z ‐score ( β = .14; P < .01), but not apnea‐hypopnea index ( β = .01; P = .72). Conclusions The relationship between OSA and EBP in adolescents is most closely associated with the degree of obesity. Further studies are needed to assess the effect of the treatment of obesity and OSA on blood pressure in adolescents.