Kang Jeongmook, Park Yoon-Hyung, Yang Kwang Ik, Cruz Jose Rene Bagani, Hwangbo Young
Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea.
J Prev Med Public Health. 2020 Jan;53(1):37-44. doi: 10.3961/jpmph.19.248. Epub 2019 Nov 6.
This study investigated the effects of comorbid sleep disorders (SD) on the incidence of cardiovascular complications among newly-diagnosed hypertension (HTN) patients.
As study population, 124 057 newly-diagnosed essential HTN patients aged 30 or older, without cardiovascular complications at diagnosis with HTN, were selected from the National Health Insurance Service-National Sample Cohort. The incidence of cardiovascular complications was calculated, Cox proportional-hazards regression model was used to analyze the risk of complications, and the population attributable fraction (PAF) for cardiovascular complications of having comorbid SD at HTN diagnosis was calculated.
Over 10 years, 32 275 patients (26.0%) developed cardiovascular complications. In HTN patients with comorbid SD at diagnosis of HTN, the incidence of cardiovascular complications (78.3/1000 person-years; 95% confidence interval [CI], 75.8 to 80.9) was higher than in those without comorbid SD (58.6/1000 person-years; 95% CI, 57.9 to 59.3) and the risk of cardiovascular complications was 1.21 times higher (95% CI, 1.17 to 1.25), adjusting for age, gender, income, area of residence, and comorbid diabetes mellitus. The PAF of having comorbid SD at diagnosis of HTN for the incidence of cardiovascular complications was 2.07% (95% CI, 1.69 to 2.44).
Newly-diagnosed essential HTN patients aged 30 or older who had comorbid SD at the time of their HTN diagnosis had a higher incidence of cardiovascular complications than those without comorbid SD. Age, gender, income, area of residence, and comorbid diabetes mellitus had a significant effect on the incidence of cardiovascular complications. Approximately 2% of cardiovascular complications were found to occur due to the presence of SD.
本研究调查了合并睡眠障碍（SD）对新诊断高血压（HTN）患者心血管并发症发生率的影响。
作为研究人群，从国民健康保险服务-全国样本队列中选取了124057例年龄在30岁及以上、新诊断为原发性高血压且诊断高血压时无心血管并发症的患者。计算心血管并发症的发生率，使用Cox比例风险回归模型分析并发症风险，并计算高血压诊断时合并SD导致心血管并发症的人群归因分数（PAF）。
在10年期间，32275例患者（26.0%）发生了心血管并发症。在高血压诊断时合并SD的高血压患者中，心血管并发症的发生率（78.3/1000人年；95%置信区间[CI]，75.8至80.9）高于无合并SD的患者（58.6/1000人年；95%CI，57.9至59.3），在调整年龄、性别、收入、居住地区和合并糖尿病后，心血管并发症的风险高1.21倍（95%CI，1.17至1.25）。高血压诊断时合并SD导致心血管并发症发生的PAF为2.07%（95%CI，1.69至2.44）。
新诊断的30岁及以上原发性高血压患者在高血压诊断时合并SD，其心血管并发症的发生率高于无合并SD的患者。年龄、性别、收入、居住地区和合并糖尿病对心血管并发症的发生率有显著影响。发现约2%的心血管并发症是由于存在SD而发生的。
