Association between refractory hypertension and obstructive sleep apnea
Bibliographic record
Abstract
BACKGROUND: Obstructive sleep apnea (OSA) increases the risk for mild hypertension, but its relationship to refractory hypertension (RHT) has not been systematically examined. We previously reported a high prevalence of OSA in patients with RHT, but did not have a control group with which to compare. Rapid eye movement (REM) sleep deprivation can raise blood pressure in animals. However, a potential relationship of OSA and REM sleep time with RHT has not been examined. OBJECTIVE: To determine whether, compared with patients with well controlled hypertension, those with RHT have a higher prevalence of OSA (apnea-hypopnea index > or = 10 per hour of sleep) and shorter REM sleep time. METHODS: We compared the prevalence of OSA and sleep structure in 42 patients with RHT with 22 patients with controlled hypertension, matched for age, sex and BMI. RESULTS: Compared with the controlled hypertension group, the RHT group had a significantly higher prevalence of OSA (81 versus 55%, P = 0.03) and less REM sleep time (47.0 +/- 4.5 versus 63.2 +/- 4.9 min, P = 0.02). Multivariate analysis revealed significantly increased odds of having RHT associated with OSA independent of other risk factors (adjusted odds ratio, 3.994; 95% confidence interval, 1.191-13.388). Reduced REM sleep time was also independently associated with the presence of RHT (adjusted odds ratio, 1.025; 95% confidence interval, 1.002-1.049). CONCLUSION: OSA and reduced REM sleep time are associated with increased odds of having RHT and, therefore, may play roles in its pathogenesis.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".