High OSA Risk independently Linked to Significant Rise in Mean Arterial Pressure in Healthy Adults, Suggests Study

Although obstructive sleep apnea (OSA) affects a massive portion of the Indian workforce, its specific impact on mean arterial pressure (MAP) in normotensive adults remains inadequately characterized. To address this clinical gap, Dr. Laishram Sanjana and colleagues from St. Peter’s Medical College assessed OSA risk prevalence and its association with MAP as a robust indicator of subclinical cardiovascular risk.

Therefore, the prospective cross-sectional study, conducted in mid-2025 at a Tamil Nadu tertiary center, utilized systematic random sampling of 144 healthy adults to compare MAP across risk groups identified via the validated STOP-BANG (Snoring, Tiredness, Observed apnea, high Blood Pressure, Body mass index, Age, Neck circumference, and Gender) questionnaire. To isolate subclinical cardiovascular risk as the primary endpoint, researchers focused on individuals aged 18–65 while excluding those with chronic comorbidities, night-shift workers, or participants using sleep-altering medications.

Key Clinical Findings of the Study Include:

• High undiagnosed prevalence: The study discovered that 16% of the healthy participants were classified as being at risk for OSA, reflecting a substantial undiagnosed burden in the local community

• Significant arterial pressure elevation: Research results demonstrated that the mean MAP was significantly higher in the at-risk group at 99.6 ± 10.2 mm Hg compared to 93.9 ± 10.8 mm Hg in low-risk individuals (p = 0.021)

• Independent predictor status: Multivariable analysis confirmed that OSA risk independently predicted a 5.19 mm Hg increase in MAP even after adjusting for smoking and alcohol use, which was the strongest predictor

• Demographic risk profiles: The investigation highlighted that at-risk individuals were significantly older, with a mean age of 42 years versus 33.6 years, and were predominantly male

• Obesity-related risk: The findings indicated that 26.9% of obese participants were in the OSA at-risk group compared to only 6.2% of individuals with a normal body mass index (BMI)

The results suggest that an elevated risk for OSA is a potent independent predictor of higher MAP in normotensive adults, with at-risk individuals showing a statistically significant mean difference of 5.7 mm Hg compared to those at low risk. This association remains relevant for healthcare providers as it indicates that OSA may contribute to subclinical cardiovascular strain well before the onset of clinical hypertension.

Thus, the study concludes that clinicians should consider that screening for OSA risk using non-invasive tools could provide a valuable opportunity for the early detection of subclinical cardiovascular risk and the implementation of preventive measures in otherwise healthy individuals.

While the study provides vital insights, it is limited by its cross-sectional design and reliance on the STOP-BANG questionnaire rather than gold-standard polysomnography, suggesting that future prospective research is needed to more definitively establish the causal link between sleep-disordered breathing and hypertension.

Reference

Sanjana L, Kumar P, Kumar N, et al. Risk of Obstructive Sleep Apnea and Its Association with Mean Arterial Blood Pressure: A Cross-sectional Study in South India. Indian J Sleep Med 2026;21(1):11–16.