Childhood OSA is an independent determinant of blood pressure in adulthood: longitudinal follow-up study. Issue 5 (24th March 2020)

• Record Type: Journal Article
• Authors: Chan, Kate Ching-ching; Au, Chun Ting; Hui, Lai Ling; Wing, Yun Kwok; Li, Albert Martin
• Is Part Of: Thorax. Volume 75:Issue 5(2020)
• Page Start: 422
• Page End: 431
• Publication Date: 2020-03-24
• Subjects: sleep apnoea -- clinical epidemiology; Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thoraxjnl-2019-213692
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Background: Current literature supports cross-sectional association between childhood obstructive sleep apnoea (OSA) and elevated blood pressure (BP). However, long-term cardiovascular outcomes in children with OSA remain unexplored. Objective: To evaluate the associations of childhood OSA with BP parameters in a prospective 10 year follow-up study. Methods: Participants were recruited from a cohort established for our previous OSA epidemiological study. They were invited to undergo clinical examination, overnight polysomnography and 24-hour ambulatory BP monitoring. Multivariate linear regression was used to assess the associations of baseline childhood OSA with BP outcomes at follow-up. Multivariable log-binomial regression was used with inverse probability weighting to assess the adjusted associations of childhood OSA with hypertension and non-dipping of nocturnal BP in adulthood. Results: 243 participants (59% male) attended the follow-up visit. The mean age was 9.8 (SD ±1.8) and 20.2 (SD ±1.9) years at baseline and follow-up respectively, with a mean follow-up duration of 10.4 (SD ±1.1) years. Childhood moderate-to-severe OSA was associated with higher nocturnal systolic blood pressure (SBP) (difference from normal controls: 6.5 mm Hg, 95% CI 2.9 to 10.1) and reduced nocturnal dipping of SBP (−4.1%, 95% CI −6.3% to 1.8%) at follow-up, adjusted for age, sex, Body Mass Index and height at baseline, regardless of the presence of OSA at follow-up. Childhood moderate-to-severe OSA was also associated with higher risk of hypertension (relative risk (RR) 2.5, 95% CI 1.2 to 5.3) and non-dipping of nocturnal SBP (RR 1.3, 95% CI 1.0 to 1.7) at follow-up. Conclusion: Childhood OSA was found to be an independent risk factor for adverse BP outcomes in adulthood.