Effects of Comorbid Sleep Disorders on Cardiovascular Complications of Hypertension Among Patients With Newly-diagnosed Hypertension: An Analysis of the Korean National Health Insurance Service-National Sample Cohort

Objectives: This study investigated the effects of comorbid sleep disorders (SD) on the incidence of cardiovascular complications among newly-diagnosed hypertension (HTN) patients. Methods: As study population, 124 057 newly-diagnosed essential HTN patients aged 30 or older, without cardiovascular complications at diagnosis with HTN, were selected from the National Health Insurance Service-National Sample Cohort. The incidence of cardiovascular complications was calculated, Cox proportional-hazards regression model was used to analyze the risk of complications, and the population attributable fraction (PAF) for cardiovascular complications of having comorbid SD at HTN diagnosis was calculated. Results: Over 10 years, 32 275 patients (26.0%) developed cardiovascular complications. In HTN patients with comorbid SD at diagnosis of HTN, the incidence of cardiovascular complications (78.3/1000 person-years; 95% confidence interval [CI], 75.8 to 80.9) was higher than in those without comorbid SD (58.6/1000 person-years; 95% CI, 57.9 to 59.3) and the risk of cardiovascular complications was 1.21 times higher (95% CI, 1.17 to 1.25), adjusting for age, gender, income, area of residence, and comorbid diabetes mellitus. The PAF of having comorbid SD at diagnosis of HTN for the incidence of cardiovascular complications was 2.07% (95% CI, 1.69 to 2.44). Conclusions: Newly-diagnosed essential HTN patients aged 30 or older who had comorbid SD at the time of their HTN diagnosis had a higher incidence of cardiovascular complications than those without comorbid SD. Age, gender, income, area of residence, and comorbid diabetes mellitus had a significant effect on the incidence of cardiovascular complications. Approximately 2% of cardiovascular complications were found to occur due to the presence of SD.