Sleep Apnea is Common in Black Adults with Uncontrolled Hypertension

Jan 10, 2019

Treating underlying sleep problems could improve hypertension treatment.

Sleep apnea could make it harder for blacks to get blood pressure under control, based on a recent study that found adults with sleep apnea were twice as likely to have hard-to-treat hypertension than those with no sleep issues. Findings were published in the American Heart Association journal Circulation, and may explain some of the increased rates of high blood pressure in blacks.

Known as the Jackson Heart Sleep Study, this study performed in-home sleep tests on 913 black adults from Jackson, Mississippi. The tests screened for sleep apnea—a disorder that occurs when breathing repeatedly stops and starts during sleep. The goal was to see just how common sleep apnea was among participants, as well as how it impacts blood pressure and other markers of health.

Between 2012 and 2016, participants completed sleep tests along with other assessments for blood pressure, weight, diabetes and other key markers of health. Overall, nearly three-quarters of participants had high blood pressure, which was defined as taking blood pressure medication, having a previous diagnosis of hypertension or having blood pressure greater than 130/80 mmHg.

Among participants with high blood pressure, 37% had their blood pressure under control and 48% did not. The remaining participants had resistant hypertension, which occurs when blood pressure remains elevated despite multiple forms of medication and treatment.

Generally speaking, any form of uncontrolled hypertension is dangerous, as high blood pressure can lead to life-threatening heart events. However, resistant hypertension is especially concerning since it can be difficult or impossible to treat with current medications.

The good news is that treating underlying sleep problems could improve hypertension treatment.

In the recent study, researchers found that one in four black adults with high blood pressure had sleep apnea, and only 6% were receiving treatment for their sleep disorder. Among participants with high blood pressure, those with moderate or severe sleep apnea were twice as likely to have resistant hypertension than those with no sleep issues. The more severe sleep apnea was, the more likely participants were to have resistant hypertension.

What this study confirms, according to authors, is the link between sleep apnea and hard-to-treat hypertension. Studies suggest that sleep apnea may be a risk factor for high blood pressure, and recent findings help strengthen this association.

Findings also help offer potential explanations behind increased rates of hypertension in blacks. It’s well established that blacks face increased risk for high blood pressure compared to whites. While half of all Americans with hypertension have their blood pressure under control, blacks are even less likely to have their condition under control, contributing to poorer outcomes.

While additional research is still needed, it’s possible that untreated sleep apnea could be contributing to these statistics. With future studies, experts hope to explore whether better screening and treatment for sleep apnea could improve blood pressure control and outcomes in black adults.

    • What is hypertension?
    • Hypertension, often referred to as high blood pressure, occurs when the force of blood against the artery walls is too high. High blood pressure is often referred to as the “silent killer,” because it often causes no symptoms and if left uncontrolled, increases the risk for heart attack and stroke.
    • What are health disparities?
    • Health disparities refer to differences in health outcomes or burdens of disease between groups of people. Health disparities can exist between different populations of race, sex, income, or even geographic location. In health care, the goal is to eliminate these differences so all individuals have the same ability to achieve good health.

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