0452 C-reactive Protein Is Associated with Hypertension in Mild-to-Moderate Obstructive Sleep Apnea: Age Effect

Abstract Introduction Mild-to-moderate obstructive sleep apnea (mmOSA) is highly prevalent in general population. It has been shown that mmOSA is a significant risk factor for the development of cardiovascular and cerebrovascular disease in young and middle-aged, but not in older adults. C-reactive protein (CRP) improves the ability to detect the individual risk for cardiovascular aberrations in young and middle-aged adults with mmOSA. However, it is unkown, whether CRP is also associated with hypertension risk in older patients with mmOSA. Methods Adults (n=208) of a wide age range (28-90 years old, mean age 52.88 ± 12.52) with mmOSA (5 ≤ AHI < 30) completed an in-lab polysomnography or home sleep testing, a physical examination including measures of blood pressure (BP) and body mass index, a structured medical history questionnaire, and a blood draw for CRP. Results In logistic regression models adjusting for sex and BMI, lnCRP but not AHI was associated with greater odds for hypertension (OR = 2.34, 95% CI = 1.19-4.62, p = 0.014, OR = 1.00, 95% CI = 0.93-1.09, p = 0.926 respectively). In adults ≥60 years neither lnCRP nor AHI were associated with hypertension (OR = 1.56, 95% CI = 0.78-3.11, p = 0.207 and OR = 1.02, 95% CI = 0.94-1.10, p = 0.690, respectively). Also, in adults aged < 60 years lnCRP was associated with greater average systolic (β = 0.214, p = 0.032) and diastolic BP (β = 0.230, p = 0.020) but not AHI (β = 0.026, p = 0. 826; β = 0.000, p = 0.998, respectively), while in adults ≥60 years neither lnCRP nor AHI were associated with greater systolic or diastolic BP. Conclusion These findings suggest that CRP is a stronger predictor of hypertension than AHI in young and middle-aged but not in older adults with mmOSA. Including a measure of CRP improves the ability for clinicians to detect cases of mmOSA at risk for hypertension in the younger group. It appears that inflammation is a primary pathogenetic mechanism in mmOSA in young and middle-aged adults but not in older ones. Support (if any)