TY - JOUR
T1 - The association of obstructive sleep apnea and left ventricular hypertrophy in obese and overweight children with history of elevated blood pressure
AU - Hanlon, Colleen E.
AU - Binka, Edem
AU - Garofano, Jeffrey S.
AU - Sterni, Laura M.
AU - Brady, Tammy M.
N1 - Funding Information:
This study was supported by grants from the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number K23HL119622‐01 (TMB), 1R56HL139620 (TMB), and T32 HL125239 (EB). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the NIH. Additional funding was provided by the Johns Hopkins University School of Medicine Dean's Office Summer Research Funding
Publisher Copyright:
©2019 Wiley Periodicals, Inc.
PY - 2019/7
Y1 - 2019/7
N2 - Obesity is a potent cardiovascular disease (CVD) risk factor and is associated with left ventricular hypertrophy (LVH). Obstructive sleep apnea (OSA) is common among individuals with obesity and is also associated with CVD risk. The authors sought to determine the association of OSA, a modifiable CVD risk factor, with LVH among overweight/obese youth with elevated blood pressure (EBP). This was a cross-sectional analysis of the baseline visit of 61 consecutive overweight/obese children with history of EBP who were evaluated in a pediatric obesity hypertension clinic. OSA was defined via sleep study or validated questionnaire. Children with and without OSA were compared using Fisher's exact tests, Student's t tests, and Wilcoxon rank sum test. Multivariable logistic regression evaluated the association between OSA and LVH. In this cohort, 71.7% of the children had LVH. Children with OSA were more likely to have LVH (85.7% vs 59.4%, P = 0.047). OSA was associated with 4.11 times greater odds of LVH (95% CI 1.15, 14.65; P = 0.030), remaining significant after adjustment for age, sex, race, and BMI z-score (after adjustment for hypertension, P = 0.051). A severe obstructive apnea-hypopnea index (AHI >10) was associated with 14 times greater odds of LVH (95% CI 1.14, 172.64, P = 0.039). OSA was significantly associated with LVH among overweight/obese youth with EBP, even after adjustment for age, sex, race, and BMI z-score. Those with the most severe OSA (AHI >10) had the greatest risk for LVH. Future studies exploring the impact of OSA treatment on CVD risk in children are needed.
AB - Obesity is a potent cardiovascular disease (CVD) risk factor and is associated with left ventricular hypertrophy (LVH). Obstructive sleep apnea (OSA) is common among individuals with obesity and is also associated with CVD risk. The authors sought to determine the association of OSA, a modifiable CVD risk factor, with LVH among overweight/obese youth with elevated blood pressure (EBP). This was a cross-sectional analysis of the baseline visit of 61 consecutive overweight/obese children with history of EBP who were evaluated in a pediatric obesity hypertension clinic. OSA was defined via sleep study or validated questionnaire. Children with and without OSA were compared using Fisher's exact tests, Student's t tests, and Wilcoxon rank sum test. Multivariable logistic regression evaluated the association between OSA and LVH. In this cohort, 71.7% of the children had LVH. Children with OSA were more likely to have LVH (85.7% vs 59.4%, P = 0.047). OSA was associated with 4.11 times greater odds of LVH (95% CI 1.15, 14.65; P = 0.030), remaining significant after adjustment for age, sex, race, and BMI z-score (after adjustment for hypertension, P = 0.051). A severe obstructive apnea-hypopnea index (AHI >10) was associated with 14 times greater odds of LVH (95% CI 1.14, 172.64, P = 0.039). OSA was significantly associated with LVH among overweight/obese youth with EBP, even after adjustment for age, sex, race, and BMI z-score. Those with the most severe OSA (AHI >10) had the greatest risk for LVH. Future studies exploring the impact of OSA treatment on CVD risk in children are needed.
KW - adolescents
KW - cardiovascular disease
KW - children
KW - hypertension
KW - left ventricular hypertrophy
KW - obesity
KW - overweight
KW - pediatrics
KW - sleep disorders
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U2 - 10.1111/jch.13605
DO - 10.1111/jch.13605
M3 - Article
C2 - 31222948
AN - SCOPUS:85067836388
SN - 1524-6175
VL - 21
SP - 984
EP - 990
JO - Journal of Clinical Hypertension
JF - Journal of Clinical Hypertension
IS - 7
ER -