Sleep-related breathing disorder in a Japanese occupational population and its association with hypertension-stratified analysis by obesity status

Minako Inoue; Satoko Sakata; Hisatomi Arima; Ikumi Yamato; Emi Oishi; Ai Ibaraki; Kenichi Goto; Takanari Kitazono

doi:10.1038/s41440-024-01612-y

Sleep-related breathing disorder in a Japanese occupational population and its association with hypertension-stratified analysis by obesity status

Hypertens Res. 2024 Mar 4. doi: 10.1038/s41440-024-01612-y. Online ahead of print.

Authors

Minako Inoue^{1

2}, Satoko Sakata^{3

4}, Hisatomi Arima⁵, Ikumi Yamato³, Emi Oishi^{3

6}, Ai Ibaraki³, Kenichi Goto^{3

7}, Takanari Kitazono^{3

6}

Affiliations

¹ Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. inoue.minako.281@m.kyushu-u.ac.jp.
² Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. inoue.minako.281@m.kyushu-u.ac.jp.
³ Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁴ Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁵ Department of Preventive Medicine and Public Health, Fukuoka University, Fukuoka, Japan.
⁶ Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁷ Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

PMID: 38438727
DOI: 10.1038/s41440-024-01612-y

Abstract

Sleep-related breathing disorder (SRBD) causes hypertension, and obesity has been highly associated with SRBD, which has become a serious health problem in young and middle-aged Japanese males. However, the relation between SRBD and hypertension considering the effects of obesity remains unknown. In this cross-sectional study, we examined the relationship between SRBD and hypertension, with consideration for the effects of obesity, in Japanese occupational population. Using 3% oxygen desaturation index (3%ODI) obtained by simplified polysomnography (PSG), participants were classified into low (0 ≤ 3%ODI < 5), medium (5 ≤ 3%ODI < 15), and high (15 ≤ 3%ODI) 3%ODI groups. We excluded employees who had not undergone medical examination with simplified PSG in the same year from 2012 to 2018. Logistic regression analysis was performed to calculate odds ratios for having hypertension according to 3%ODI levels. In total, 2532 employees were included. Among them, 25% and 4% were categorized into the medium and high 3%ODI groups, respectively. The odds ratio for hypertension increased significantly with higher 3%ODI levels after adjustment for age, sex, alcohol drinking status and smoking status (p for trend < 0.0001). However, further adjustment for obesity status (body mass index ≥ 25 kg/m²) attenuated the associations. When we performed the stratified analysis by obesity status, the odds ratio for hypertension increased significantly with higher 3%ODI only for non-obese individuals, with significant interaction (p for interaction = 0.014). Higher 3%ODI was significantly associated with higher prevalence of hypertension especially in non-obese participants, suggesting the importance of vigilance for the presence of SRBD even in non-obese individuals. We investigated the association between SRBD and hypertension considering the effects of obesity, which would suggest the need to keep in mind the presence of SRBD even in non-obese individuals.

Keywords: Hypertension; Obesity; Sleep-related breathing disorder.