PS-C32-5: GENDER DIFFERENCE IN HYPERTENSIVE PATIENTS ASSOCIATED WITH PROBABLE OSA

Abstract

Objectives: Obstructive Sleep Apnea (OSA) has high association with hypertension and cardiovascular disease. OSA has been widely proven to be more common in men than women possibly due to pathophysiological difference and clinical presentations. However, there are limited studies on assessing the gender difference in correlation between OSA and hypertensive patients. This study aimed to examine the determinants of probable OSA according to gender among hypertensive patients in primary care clinics. Design and Methods: A cross-sectional study was carried out using systematic random sampling method in hypertensive patients who attended two government primary care clinics in Sarawak, Malaysia. A validated STOP-Bang questionnaire was used in this study and socio-demographic data was captured with questionnaire. Probable OSA was defined as STOP BANG score of 3 and above. SPSS version 23 was used to do the analysis and multivariate logistic regressions were used to determine the determinants of probable OSA according to gender. Results: 440 hypertensive patients were enrolled into this study, 60.7% of them were female. There was a higher proportion of male patients (92.5%) found to have probable OSA as compared to female patients (30%) (p < 0.001). Looking into criteria of STOP BANG, between female and male patients, there were significant differences in daytime symptoms (p = 0.020) and BMI categories (p = 0.001). As for demographic data, the determinant of probable OSA in men were low income (<RM3,000) (AOR = 4.320, P = 0.022, 95% confidence interval [CI] 1.23,15.15), longer duration of hypertension (AOR = 1.269, P = 0.029, 95% CI 1.03,1.57) and being married (AOR = 5.612, P = 0.021, 95% CI 1.30,24.22). For female, the determinant of probable OSA were neck circumference (AOR = 1.613, P = 0.002, 95% CI 1.19,2.81) and Chinese ethnicity (AOR = 11.711, P = 0.013, 95% CI 1.67,81.95). Conclusion: In conclusion, this study reported that among hypertensive patients, OSA is more prevalent in men than women, and criteria of STOP BANG and clinical characteristics are significantly different between gender. Primary care clinicians should be aware of these difference and screen for probable OSA accordingly for further early intervention.