High risk for obstructive sleep apnea and risk of hypertension in military personnel: The CHIEF sleep study

BACKGROUND Epidemiological studies have revealed an association between obstructive sleep apnea(OSA)and hypertension in the general population,while the association in military personnel was rarely investigated.AIM To examine the association between high risk for OSA and hypertension by phenotypes in military young adults.METHODS A total of 746 military personnel,aged 27.9 years,were included in the cardiorespiratory fitness and health in armed forces(CHIEF)-sleep study in Taiwan in 2020.Antihypertensive medications were not used by the subjects.High risk for OSA was assessed using the Berlin Questionnaire.Hypertension was defined using the 7th Report of the Joint National Committee on Prevention,Detection,Evaluation,and Treatment of High Blood Pressure(JNC 7)and the 2017 American College of Cardiology(ACC)/American Heart Association(AHA)guidelines.The cutoff levels of systolic and diastolic blood pressure(SBP and DBP)for the 2017 ACC/AHA-and JNC 7-based guidelines were 130/140 mmHg and 80/90 mmHg,respectively.Hypertension phenotypes included isolated systolic and diastolic hypertension(ISH,high SBP only and IDH,high DBP only)and combined hypertension(both high SBP and DBP).Multivariable logistic regression analysis with adjustment for demographics,lifestyle and metabolic biomarkers.RESULTS The prevalence of high risk for OSA,JNC 7-based hypertension and 2017 ACC/AHA-based hypertension were 8.0%,5.2%and 22.0%,respectively.Those with a high risk for OSA had a higher probability of JNC 7-based overall and combined hypertension(odds ratios(ORs))and 95%confidence intervals:2.82(1.07-7.42)and 7.54(1.10-51.54),although the probabilities of ISH and IDH were unaffected by a high risk for OSA(ORs:1.96 and 2.35,respectively,both P>0.05).In contrast,no associations for any hypertension phenotypes were found according to the 2017 ACC/AHA criteria.CONCLUSION A high risk for OSA was associated with severe hypertension and combined hypertension among Asian military young adults.

Rationale and design of the cardiorespiratory fitness and hospitalization events in armed forces study in Eastern Taiwan

AIM To investigate the association between cardiorespiratory fitness and hospitalization events in a cohort of large voluntary arm forces in Taiwan. METHODS The cardiorespiratory fitness and hospitalization events in armed forces(CHIEF) is a retrospective cohort consisting of more than 4000 professional military members aged 18-50 years in Eastern Taiwan. All participants received history taking, physical examination, chest radiography, 12-lead electrocardiography, blood tests for cell counts and fasting glucose, lipid profiles, uric acid, renal function and liver function in the Hualien Armed Forces General Hospital during 2014. In addition, participants were required to undergo two indoor resistant exercise tests including 2-min push-up and 2-min sit-up, both scored by infrared sensing, and one outdoor endurance 3000-m none weight-bearing running test, the main indicator of cardiorespiratory fitness in the Military Physical Training and Testing Center in Eastern Taiwan in 2014. RESULTS Hospitalization events for cardiovascular disease, acute kidney injury, rhabdomyolysis, severe infectious disease, acute psychiatric illness, diabetes, orthopedic surgery and mortality will be identified in the National Insurance Research Database for 10 years. CONCLUSION CHIEF will be among the largest Eastern Asian armed forces cohort, in which physical status was strictly evaluated to follow up the hospitalization events for severe illness.