Causal Associations Between Obstructive Sleep Apnea and Hypertension: Evidence From a Bidirectional and Multivariable...

Area of Science:

• Cardiovascular Health
• Sleep Medicine
• Genetics

Background:

• Obstructive sleep apnea (OSA) and hypertension are significant health concerns.
• The genetic link between OSA and hypertension risk is not well understood.

Purpose of the Study:

• To investigate the potential causal relationship between OSA and hypertension using bidirectional Mendelian randomization (MR).
• To explore the role of heredity in the association between OSA and hypertension.

Main Methods:

• Bidirectional two-sample MR analysis utilizing single-nucleotide polymorphisms (SNPs) from large GWAS.
• Inverse-variance weighted (IVW) method as the primary analysis, with MR-Egger, MR-PRESSO, and leave-one-out analyses for sensitivity.
• Multivariable MR (MVMR) was employed to adjust for confounding factors like BMI, smoking, and alcohol consumption.

Main Results:

• Forward MR indicated an association between OSA and increased hypertension risk, DBP, and sibling hypertension risk, which disappeared after adjusting for confounders.
• Reverse MR revealed a causal effect of paternal hypertension on elevated OSA risk (OR, 3.803; p=0.030).

Conclusions:

• The observed association between OSA and hypertension is likely confounded by factors such as BMI, smoking, and alcohol consumption.
• Paternal hypertension may be a significant risk factor for developing obstructive sleep apnea.