Abstract MP63: Childhood-onset Obstructive Sleep Apnea Is Associated With Increased Risk Of Adolescent Hypertension

Abstract

Introduction: Obstructive sleep apnea (OSA) is an established risk factor for hypertension in adults. However, the association of childhood OSA with an increased risk of hypertension has remained elusive. Hypothesis: Childhood-onset OSA is longitudinally associated with hypertension in adolescence. Methods: We tested this hypothesis in a population-based sample of 421 children (5-12 years) from the Penn State Child Cohort who were followed-up 6-13 years later as adolescents (12-23 years). In-lab polysomnography, to ascertain the apnea/hypopnea index (AHI), and seated blood pressure were assessed at baseline and at follow-up. The presence of hypertension at follow-up was defined based on pediatric criteria dependent upon the subject’s age (below and above 13 years). Logistic regression analyses adjusted for sex, race/ethnicity, age, body mass index percentile and systolic blood pressure percentile at baseline. Results: Childhood OSA that persisted in the transition to adolescence was associated with 2.9-fold (95%CI=1.1-7.4) higher odds of adolescent hypertension. In contrast, childhood OSA that remitted in the transition to adolescence was not associated with increased odds of adolescent hypertension (OR=0.9, 95%CI=0.3-2.6). Adolescent-onset OSA was associated with 1.7-fold (95%CI=1.1-2.9) increased odds of adolescent hypertension. Conclusions: Childhood-onset persistent OSA is a risk factor for hypertension in adolescence. Remission of childhood OSA during this transitional period, which previous research has shown to be highly determined by weight loss, does not confer a significant risk of adolescent hypertension. Early life chronic adverse sleep exposures predict cardiovascular risk in adolescence, a critical developmental period.