OSAS.MAP10与高血压患者全因死亡风险：基于NHANES的回顾性队列分析
OSAS.MAP10 and all-cause mortality risk in hypertensive patients: a retrospective cohort analysis of NHANES.
文献信息
| PMID | 42754840 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Xuerong Shen |
| 作者单位 | The Graduate School of Fujian Medical University, Fuzhou, China. |
| 期刊 | Blood pressure |
| SCI 分区 | Q2 |
| IF | 2.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景与研究问题： 高血压与阻塞性睡眠呼吸暂停（OSA）在老年人中常共存。OSAS.MAP10是一种基于症状的筛查评分，用于评估OSA风险，而非多导睡眠图严重程度指标。我们研究了其与全因死亡率的关联，并探讨了高血压成人中的非线性模式。
方法： 我们分析了来自NHANES 2005-2008年和2015-2018年的6930名高血压成人。主要结局为全因死亡率；心血管死亡率和癌症死亡率为次要结局。我们使用了调查加权的Cox模型和限制性立方样条，并调整了年龄、性别、种族和族裔、BMI、教育程度、家庭贫困收入比、吸烟状况、糖尿病、基线心血管疾病、当前降压药物使用以及调查周期。在年龄≥60岁的成人中，以不含连续年龄的年龄分层模型为主要模型，并将额外调整连续年龄作为敏感性分析进行评估。
结果： 在6930名高血压成人中，共发生1199例死亡。在年龄≥60岁参与者（n=3982；1006例死亡）的完整病例分析中，OSAS.MAP10与死亡率的关联呈非线性（非线性P<0.001）。在不含连续年龄的年龄分层模型中，每增加1分且达到或超过6.19与更高的死亡率相关（HR 1.21；95% CI 1.02-1.44；p=0.029）。在额外调整年龄后，该关联减弱（HR 0.96；95% CI 0.83-1.12；p=0.643）。心血管死亡率未显示显著非线性。
结论： 在年龄≥60岁的高血压成人中，较高的OSAS.MAP10评分与全因死亡率呈非线性关联。约6.2以上的增加仅在不调整连续年龄时观察到，此后减弱。该拐点具有假设生成意义，需要在独立队列中验证。
英文摘要
BACKGROUND AND RESEARCH QUESTION: Hypertension and obstructive sleep apnoea (OSA) commonly coexist in older adults. OSAS.MAP10 is a symptom-based screening score estimating OSA risk, not a polysomnographic severity measure. We examined its association with all-cause mortality, and explored nonlinear patterns among hypertensive adults.
METHODS: We analysed 6930 hypertensive adults from NHANES 2005-2008 and 2015-2018. The primary outcome was all-cause mortality; cardiovascular and cancer mortality were secondary outcomes. We used survey-weighted Cox models and restricted cubic splines adjusting for age, sex, race and ethnicity, BMI, education, family poverty income ratio, smoking status, diabetes, baseline cardiovascular disease, current antihypertensive medication use, and survey period. In adults aged ≥60 years, the age-stratified model without continuous age was primary, and additional continuous-age adjustment was evaluated as a sensitivity analysis.
RESULTS: Among 6930 hypertensive adults, 1199 deaths occurred. In the complete-case analysis of participants aged ≥60 years (n = 3982; 1006 deaths), the OSAS.MAP10-mortality association was nonlinear (P for nonlinearity <0.001). In the age-stratified model without continuous age, each 1-point increase at or above 6.19 was associated with higher mortality (HR 1.21; 95% CI 1.02-1.44; p = 0.029). After age additional adjustment , the association was attenuated (HR 0.96; 95% CI 0.83-1.12; p = 0.643). Cardiovascular mortality showed no significant nonlinearity.
CONCLUSIONS: Higher OSAS.MAP10 scores showed a nonlinear association with all-cause mortality among hypertensive adults aged ≥60 years. The increase above approximately 6.2 was observed only without continuous age adjustment and was attenuated thereafter. This inflection point is hypothesis-generating and requires validation in an independent cohort.