Risk Factors for Pulmonary Hypertension Combined With Obstructive Sleep Apnea

Obstructive Sleep Apnea, tablet, stethoscope
Obstructive Sleep Apnea, tablet, stethoscope
A recent Chinese study sought to identify clinical predictors of pulmonary hypertension combined with obstructive sleep apnea.

Lower daytime arterial oxygen pressure (PaO2) is a risk factor for obstructive sleep apnea (OSA) in older male patients with pulmonary hypertension (PH), according to a single-center study published in BMC Pulmonary Medicine.

OSA is more common in patients with PH than without PH. However, the degree of correlation is generally mild and therefore OSA is often overlooked in the diagnosis, risk stratification, and treatment of PH.

To address the lack of data on the association between PH and OSA, researchers at Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science designed a study to understand the incidence and clinical characteristics of OSA in patients with PH and to explore possible predictors of PH combined with OSA. They included patients with PH diagnosed by right heart catheterization who underwent overnight cardiorespiratory monitoring from 2018 to 2020.

Out of 140 patients with PH studied, investigators found that 35 (25%) had OSA, concluding that OSA is relatively frequent in patients with PH, especially in patients with chronic thromboembolic PH and patients with lung disease- or hypoxia-associated PH. The researchers also found that patients who had OSA were mostly male and had a higher age and a lower daytime arterial oxygen pressure. Logistic regression analysis was run to determine the risk factors for OSA in PH patients and it confirmed that older age, male sex, and lower daytime arterial blood oxygen pressure correlated with OSA in PH patients.

According to the researchers, “OSA may aggravate PH to some extent, and advanced age, male sex and lower daytime PaO2 could predict the presence of OSA.” They added, “It may be important to identify and treat PH patients with OSA.” In addition, researchers recommended further investigation of the clinical significance of PH with OSA.


Yan L, Zhao Z, Zhao Q, et al. The clinical characteristics of patients with pulmonary hypertension combined with obstructive sleep apnoea. BMC Pulm Med. 2021;21(1):378.  doi:10.1186/s12890-021-01755-5