成人顽固性高血压患者阻塞性睡眠呼吸暂停的风险

Raj Desai, Haesuk Park, Joshua D. Brown, Steven M. Smith
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引用次数: 1

摘要

抵抗性高血压(RH)患者发生阻塞性睡眠呼吸暂停(OSA)的风险尚未得到很好的量化。我们试图通过时间依赖性暴露分析来评估RH患者与接受治疗但无耐药性高血压(非RH)患者发生OSA的风险。2008年1月至2019年12月,我们使用IBM MarketScan®商业索赔数据库对接受治疗的高血压患者(1年内高血压诊断+≥2例降压药索赔)进行了一项回顾性队列研究。我们排除了在第二个降压药填充日期(队列输入的指标日期)之前没有连续入组12个月的患者和在指标前12个月内有结果(OSA)的患者。我们采用Cox比例风险回归,OSA为因变量,时间依赖性暴露(非RH与RH)和基线协变量为自变量。在1375055名接受治疗的高血压患者中,13584名患者被归类为暴露于RH。在多变量Cox比例风险模型中,暴露于RH与OSA风险增加60%相关(调整后的风险比(aHR):1.60;95%CI,1.52–1.68)。研究结果表明,与非RH相比,暴露于RH与OSA发生的风险更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk of Obstructive Sleep Apnea in Adults with Resistant Hypertension
The risk of obstructive sleep apnea (OSA) in patients with resistant hypertension (RH) has not been well-quantified. We sought to evaluate the risk of OSA in patients with RH compared to those with treated but non-resistant hypertension (non-RH) using a time-dependent-exposure analysis. We conducted a retrospective cohort study of patients with treated hypertension (hypertension diagnosis + ≥2 antihypertensive drug claims within 1 year) using the IBM MarketScan® commercial claims database from January 2008 to December 2019. We excluded patients without 12 months of continuous enrollment before the second antihypertensive fill date (index date of cohort entry) and those having the outcome (OSA) in the 12-month pre-index period. We employed Cox proportional hazard regression with OSA as the dependent variable, and time-dependent exposure (non-RH vs. RH) and baseline covariates as independent variables. Of the 1,375,055 patients with treated hypertension, 13,584 patients were categorized as exposed to RH. In the multivariable Cox proportional hazards model, exposure with RH was associated with a 60% increased risk of OSA (adjusted hazard ratio (aHR): 1.60; 95% CI, 1.52–1.68) compared to non-RH exposure. Findings of the study suggest that exposure with RH, compared to non-RH, is associated with a higher risk of incident OSA.
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