Sleep apnea and hypertension: prevalence in chronic kidney disease

The authors sought to evaluate the prevalence of hypertension (HTN) in patients with sleep apnea (SA) who had normal kidney function and in patients with SA and chronic kidney disease (CKD). It has not been determined whether there is an effect of interplay of SA and CKD on the prevalence of HTN. In this study, the diagnosis of CKD was established based on the glomerular filtration rate and the presence of proteinuria. SA and HTN were diagnosed based on International Classification of Diseases, Ninth Revision coding, Current Procedural Terminology coding, and medication use. Using the database of a large integrated health system, 434,388 patients aged 18 years and older with 2 or more years of continuous enrollment during January 2002 to December 2004 were analyzed. The HTN rate with SA alone was 51%, compared with 70.2% with SA and CKD. The overall prevalence of HTN was 28% in patients without CKD or SA. The prevalence ratio for HTN was 1.36 (95% confidence interval, 1.33-1.39) more prevalent in patients with SA and CKD compared with patients with SA without CKD. The high prevalence of HTN in patients with SA and CKD suggests the need for evaluation of SA in patients with concurrent HTN and CKD.