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Effects of Comorbid Sleep Disorders on Cardiovascular Complications of Hypertension among Patients with Newly-diagnosed Hypertension: An Analysis of the Korean National Health Insurance Service-National Sample Cohort
Jeongmook Kang1 , Yoon-Hyung Park1 , Kwang Ik Yang2 , Jose Rene Bagani Cruz1 , Young Hwangbo1
1Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheoan, Korea
2Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheoan, Korea
Corresponding Author: Young Hwangbo ,Tel: 82 41 570 2480, Fax: 82 41 575 2406, Email: hbyoung@sch.ac.kr
Received: September 4, 2019;  Accepted: November 6, 2019.
ABSTRACT
Objectives:
This study investigated the effects of comorbid sleep disorders on the incidence of cardiovascular complications among newly-diagnosed hypertension patients.
Method:
As study population, 124,057 newly-diagnosed essential hypertension patients aged 30 or older, without cardiovascular complications at diagnosis with hypertension, were selected from the National Health Insurance Service-National Sample Cohort. The incidence of cardiovascular complications was calculated, a Cox proportional-hazards regression model was used to analyze the risk of complications, and the population attributable fraction (PAF) for cardiovascular complications of having comorbid sleep disorders at hypertension diagnosis was calculated.
Results:
Over 10 years, 32,275 patients (26.02%) developed cardiovascular complications. In hypertension patients with comorbid sleep disorders at diagnosis of hypertension, the incidence of cardiovascular complications (78.3/1000 person-years; 95% CI, 75.8-80.9) was higher than in those without comorbid sleep disorders (58.6/1000 person-years; 95% CI, 57.9-59.3) and the risk of cardiovascular complications was 1.21 times higher (95% CI, 1.17-1.25), adjusting for age, gender, income, area of residence, and comorbid diabetes mellitus. The PAF of having comorbid sleep disorders at diagnosis of hypertension for the incidence of cardiovascular complications was 2.07% (95% CI, 1.69%-2.44%).
Conclusions:
Newly-diagnosed essential hypertension patients aged 30 or older who had comorbid sleep disorders at the time of their hypertension diagnosis had a higher incidence of cardiovascular complications than those without comorbid sleep disorders. Age, gender, income, area of residence, and comorbid diabetes mellitus had a significant effect on the incidence of cardiovascular complications. Approximately 2% of cardiovascular complications were found to occur due to the presence of sleep disorders.
Key words: Essential Hypertension; Sleep Wake Disorders; Cardiovascular Disease
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