Is Oropharyngeal Crowdedness a Risk Factor for High Blood Pressure?

Abstract

Background: Snoring is a sign of partial upper airway obstruction from oropharyngeal crowdedness during sleep but little is known about its association with essential hypertension in black Africans.  Aim: To determine prevalence of hypertension among adult snorers and its relationship with selected indices of oropharyngeal crowdedness. Methods: It is a cross-sectional study of adults in Oyo Rural Community. Questionnaire was administered to obtain data on socio-demography, daytime sleepiness, snoring, duration of overnight sleep. Those with chronic medical conditions and past surgical procedures in the nose or throat were excluded. Oropharyngeal crowdedness was assessed using Mallampati scoring and Brodsky tonsillar grading methods. Participants’ neck circumference and blood pressure were measured. The body mass indices (BMI) were determined. Statistical analysis was performed with IBM- SPSS version 20 and level of significance was at set at p value ˂ 0.05. Results: There were 408 participants consisting 191(46.8%) snorers and 217 (53.2%) non- snorers. Fifty-one (12.5%) participants have hypertension comprising of 27 (52.9%) snorers and 24 (47.1 %) non-snorers. Mean BMI for male and female were 23.79 kg/m2 ±3.93 and 24.86 kg/m2 ± 4.9 respectively. Mean neck circumference was 34.08±2.7 cm and duration of overnight sleep was 8.2±1.4 hours.  Mallampati score I, II, III and IV were in 94 (23.0%), 148 (36.3%), 121 (29.7%) and 45 (11.0%) participants respectively, and Brodsky tonsillar grade 0, 1, 2, and 3 were observed in 293 (71.8%), 70 (17.2%), 33 (8.1 %) and 12 (2.9 %) participants respectively. There was a significant association between hypertension and neck circumference (p < 0.047), and Mallampati (p < 0.001), but no association with enlarged tonsil (p = 0.203), gender (p = 0.407), BMI (p < 0.68), overnight sleep duration (p = 0.37) and daytime sleepiness (p = 0.908). Conclusion: There was no significant correlation between snoring and hypertension, but the risk factors for the hypertension were increased age, increased neck circumference and high Mallampati score.