Lindberg E, Janson C, Gislason T, Svärdsudd K, Hetta J, Boman G
Dept of Lung Medicine and Asthma Research Centre, Uppsala University, Akademiska sjukhuset, Sweden.
Eur Respir J. 1998 Apr;11(4):884-9. doi: 10.1183/09031936.98.11040884.
In many cross-sectional studies an association has been found between snoring and hypertension. However, differing results have been obtained when confounding factors have been taken into account. To establish whether snoring is a risk factor for developing hypertension, a population-based, prospective survey was performed. In 1984 and 1994, 2,668 males, aged 30-69 yrs at baseline, answered questionnaires concerning sleep disturbances and somatic disease. Of the habitual snorers in 1984, 12.5% reported that they had developed hypertension during the period, compared with 7.4% of the remaining subjects (p<0.001). In a multiple logistic regression model persistent snoring, i.e., reported habitual snoring in both 1984 and 1994, was found to be an independent predictor for the development of hypertension among males aged 30-49 yrs (odds ratio 2.6, 95% confidence interval 1.5-4.5) after adjustments for age, body mass index (BMI), weight gain, smoking, alcohol dependence, and physical inactivity. Among the subjects aged 50-69 yrs in 1984, no association between snoring and development of hypertension was found. Although based only on reported data, the results indicate that persistent snoring is an independent risk factor for the development of hypertension among males aged <50 yrs. Prospective surveys, including whole-night sleep recordings, are needed to establish whether this is due to a higher prevalence of obstructive sleep apnoea syndrome among snorers or whether nonapnoeic snorers with increased upper airway resistance also have an increased risk of developing hypertension.
在许多横断面研究中，已发现打鼾与高血压之间存在关联。然而，在考虑混杂因素时，却得到了不同的结果。为确定打鼾是否为高血压发生的危险因素，开展了一项基于人群的前瞻性调查。1984年和1994年，对2668名基线年龄为30 - 69岁的男性进行了有关睡眠障碍和躯体疾病的问卷调查。在1984年的习惯性打鼾者中，有12.5%报告在此期间患了高血压，而其余受试者中这一比例为7.4%（p<0.001）。在一个多元逻辑回归模型中，经年龄、体重指数（BMI）、体重增加、吸烟、酒精依赖和缺乏身体活动等因素调整后，发现持续性打鼾（即在1984年和1994年都报告有习惯性打鼾）是30 - 49岁男性高血压发生的独立预测因素（比值比2.6，95%置信区间1.5 - 4.5）。在1984年年龄为50 - 69岁的受试者中，未发现打鼾与高血压发生之间存在关联。尽管仅基于报告的数据，但结果表明持续性打鼾是<50岁男性高血压发生的独立危险因素。需要进行包括整夜睡眠记录的前瞻性调查，以确定这是由于打鼾者中阻塞性睡眠呼吸暂停综合征的患病率较高，还是上气道阻力增加的非呼吸暂停性打鼾者患高血压的风险也增加。
