Moderate or Severe Sleep Apnea Doubles Risk of Hard-to-Treat Hypertension in African Americans

African Americans with moderate or severe sleep apnea are twice as likely to have hard-to-control high blood pressure when their sleep apnea goes untreated, according to a new study funded mainly by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health. The findings, which researchers say may partially explain why African Americans suffer hypertension at rates higher than any other group, point to screening and treatment of sleep apnea as another important strategy for keeping uncontrolled high blood pressure at bay.
A common disorder that blocks the upper airways and causes people to stop breathing during sleep, sleep apnea already has been linked to an increased risk of high blood pressure in whites, but the association in blacks has been largely understudied. This new research demonstrates this link in a large population of African-Americans. The results are scheduled to be published Dec. 10 in Circulation, a journal of the American Heart Association.
“This is an example of how NHLBI funded research is making important advances to our basic understanding of cardiovascular risk and sleep health,” said Michael Twery, Ph.D., director of the National Center on Sleep Disorders Research at NHLBI. “This report underscores the need for studies to determine whether screening groups at high risk for sleep apnea, such as African-Americans, would facilitate early medical intervention and reduce the risk or severity of heart disease.”
“This study identifies a risk factor for hard-to-control hypertension that until now has gone under-recognized in African Americans,” said study leader Dayna Johnson, Ph.D., an assistant professor in the Department of Epidemiology at Rollins School of Public Health at Emory University in Atlanta. Johnson added that the disproportionately high rate of uncontrolled hypertension among African Americans makes the study results even more consequential. A recent NIH-funded study showed that about 75 percent of African-American men and women are likely to develop high blood pressure by age 55, compared to 55 percent of white men and 40 percent of white women of the same age.
Johnson noted that the current findings could provide more of an impetus for African Americans with the condition to get evaluated for sleep apnea, which also appears to affect them more than it does whites. An estimated 1 in 4 African Americans in the United States have moderate or severe sleep apnea, but most have not been diagnosed or treated by a doctor, according to a 2018 study led by Johnson when she worked at Brigham and Women’s Hospital in Boston.
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