High risk for obstructive sleep apnea and risk of hypertension in military personnel: The CHIEF sleep study

Table 1 Characteristics of Participants Reporting Berlin Questionnaire

	Low risk for OSA (n = 686)	High risk for OSA (n = 60)	P value
Age, yr	27.67 ± 5.74	30.45 ± 5.86	< 0.001
Male sex, %	601 (87.6)	55 (91.7)	0.35
Tobacco consumption, %	286 (41.7)	32 (53.3)	0.08
Alcohol intake, %	242 (38.0)	27 (45.0)	0.16
Night sentry duty%
0/mo	373 (54.4)	28 (46.7)	0.26
1/mo	87 (12.7)	6 (10.0)
≥ 2/mo	226 (32.9)	26 (43.3)
Time for a 3000-m run, s	900.44 ± 117.15	949.19 ± 255.01	0.008
Body mass index, kg/m2	24.11 ± 3.65	27.75 ± 4.27	< 0.001
Waist circumference, cm	81.20 ± 9.63	92.04 ± 13.79	< 0.001
Systolic blood pressure, mmHg	116.32 ± 12.17	120.41 ± 16.28	0.01
Diastolic blood pressure, mmHg	68.79 ± 9.01	72.77 ± 12.41	0.002
Hypertension (JNC 7)	29 (4.2)	10 (16.7)	< 0.001
ISH	16 (2.3)	4 (6.7)	< 0.001
IDH	11 (1.6)	3 (5.0)
CH	2 (0.3)	3 (5.0)
Hypertension (2017 ACC/AHA)	147 (21.4)	17 (28.3)	0.21
ISH	63 (9.2)	5 (8.3)	0.02
IDH	40 (5.8)	2 (3.3)
CH	44 (6.4)	10 (16.7)
Blood test
Total cholesterol, mg/dL	170.51 ± 31.56	178.15 ± 31.02	0.07
Low-density lipoprotein, mg/dL	103.97 ± 28.64	109.93 ± 26.58	0.12
High-density lipoprotein, mg/dL	50.91 ± 10.80	46.93 ± 9.90	0.006
Serum triglycerides, mg/dL	98.65 ± 71.06	143.65 ± 122.28	< 0.001
Fasting glucose, mg/dL	94.90 ± 10.00	94.75 ± 10.12	0.91
Serum uric acid, mg/dL	6.42 ± 1.42	6.95 ± 1.41	0.006

ACC: American College of Cardiology; AHA: American Heart Association; CH: combined hypertension; IDH: Isolated diastolic hypertension; ISH: Isolated systolic hypertension; JNC: Joint National Committee hypertension guideline; OSA: Obstructive sleep apnea.

Table 2 Multivariable Logistic Regressions of High Risk for Obstructive Sleep Apnea with 7^th Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) Based Hypertension Phenotypes

	JNC 7 based hypertension			JNC 7 based hypertension phenotypes
				ISH			IDH			CH
	OR	95%CI	P value	OR	95%CI	P value	OR	95%CI	P value	OR	95%CI	P value
Model 1	4.28	1.82-10.08	0.001	2.75	0.76-9.93	0.12	3.21	0.66-15.57	0.14	19.27	3.14-118.29	0.001
Model 2	3.95	1.61-9.67	0.003	2.66	0.71-9.92	0.14	3.05	0.59-15.89	0.18	13.75	2.14-88.50	0.006
Model 3	3.63	1.44-9.16	0.006	2.51	0.66-9.54	0.17	2.96	0.55-15.92	0.2	11.5	1.67-79.03	0.01
Model 4	2.82	1.07-7.46	0.03	1.96	0.49-7.83	0.33	2.35	0.39-14.33	0.35	7.54	1.10-51.54	0.03

Data are presented as odds ratio (OR) and 95% confidence intervals (CI). Model 1: Unadjusted. Model 2: Age, sex, alcohol intake, cigarette smoking and time for a 3000-m run. Model 3: Model 2 + total cholesterol, high-density lipoprotein, low-density lipoprotein, serum triglycerides and serum uric acid. Model 4: Model 3 + body mass index. CH: Combined hypertension; IDH: Isolated diastolic hypertension; ISH: Isolated systolic hypertension; JNC: Joint National Committee hypertension guideline.

Table 3 Multivariable Logistic Regressions of High Risk for Obstructive Sleep Apnea with 2017 American College of Cardiology/American Heart Association Based Hypertension Phenotypes

	2017 ACC/AHA based hypertension			2017 ACC/AHA based hypertension phenotypes
				ISH			IDH			CH
	OR	95%CI	P value	OR	95%CI	P value	OR	95%CI	P value	OR	95%CI	P value
Model 1	1.38	0.74-2.58	0.31	1.06	0.40-2.81	0.90	0.67	0.15-2.87	0.58	2.53	1.10-5.79	0.02
Model 2	1.08	0.56-2.10	0.81	0.97	0.36-2.61	0.95	0.35	0.06-2.00	0.23	1.95	0.81-4.68	0.13
Model 3	0.94	0.47-1.87	0.85	0.85	0.31-2.34	0.75	0.30	0.05-1.72	0.17	1.69	0.68-4.23	0.26
Model 4	0.77	0.38-1.58	0.48	0.66	0.24-1.86	0.43	0.32	0.06-1.74	0.18	1.38	0.53-3.62	0.51

Data are presented as odds ratio (OR) and 95% confidence intervals (CI). Model 1: Unadjusted. Model 2: Age, sex, alcohol intake, cigarette smoking and time for a 3000-m run. Model 3: Model 2 + total cholesterol, high-density lipoprotein, low-density lipoprotein, serum triglycerides and serum uric acid. Model 4: Model 3 + body mass index. ACC: American College of Cardiology; AHA: American Heart Association; CH: Combined hypertension; IDH: Isolated diastolic hypertension; ISH: Isolated systolic hypertension.

Table 4 Subgroup Analyses for the Association of High Risk for Obstructive Sleep Apnea with Hypertension Phenotypes According to Age and Abdominal Obesity and Night Sentry Duty Status

Variables	JNC 7 based hypertension			2017 ACC/AHA based hypertension
	OR	95%CI	P value	OR	95%CI	P value
Age
< 30 yr	2.07	0.35-12.07	0.42	1.34	0.49-3.66	0.56
≥ 30 yr	4.55	1.50-13.78	0.007	0.83	0.34-2.02	0.67
Abdominal obesity (based on WS)
< 90 cm in men, < 80 cm in women	5.83	1.42-23.95	0.01	1.58	0.59-4.23	0.36
≥ 90 cm in men, ≥ 80 cm in women	2.01	0.64-6.26	0.23	0.55	0.22-1.38	0.2
Night sentry duty
0/mo	5.28	1.35-20.71	0.01	0.87	0.31-2.41	0.78
≥ 1/mo	2.73	0.62-11.99	0.18	1.29	0.49-3.43	0.6

Data are presented as odds ratio (OR) and 95% confidence intervals (CI). Multivariable logistic regression was used to determine the association with adjustment for Age, sex, alcohol intake, cigarette smoking and time for a 3000-m run, total cholesterol, high-density lipoprotein, low-density lipoprotein, serum triglycerides, serum uric acid and body mass index. ACC: American College of Cardiology; AHA: American Heart Association; WS: Waist circumference; JNC: Joint National Committee hypertension guidelines.