# Further insights into influence factors of hypertension in older patients with obstructive sleep apnea syndrome: a model based on multiple centers

## TL;DR

This study creates a model and scoring system to predict hypertension in older patients with obstructive sleep apnea syndrome, using factors like age and BMI.

## Contribution

The novel contribution is a predictive model and scoring system for hypertension in older OSAS patients based on multiple clinical factors.

## Key findings

- Age, BMI, AHI, TB, HDL-C, and FBG were significant predictors of hypertension in OSAS patients.
- The model and scoring system showed comparable predictive ability with AUCs of 0.714 and 0.662.
- The calibration curve confirmed the model's predictions aligned well with actual hypertension risk.

## Abstract

To construct a novel model or a scoring system to predict hypertension comorbidity in older patients with obstructive sleep apnea syndrome (OSAS).

A total of 1290 older patients with OSAS from six tertiary hospitals in China were enrolled. The sample was randomly divided into a modeling set (80%) and validation set (20%) using a bootstrap method. Binary logistic regression analysis was used to identify influencing factors. According to the regression coefficients, a vivid nomogram was drawn, and an intuitive score was determined. The model and score were evaluated for discrimination and calibration. The Z-test was utilized to compare the predictive ability between the model and scoring system.

In the multivariate analysis, age, body mass index (BMI), apnea–hypopnea index (AHI), total bilirubin (TB), high-density lipoprotein cholesterol (HDL-C), and fasting blood glucose (FBG) were significant predictors of hypertension. The area under the receiver operating characteristic curve of the model in the modeling and validation sets was 0.714 and 0.662, respectively. The scoring system had predictive ability equivalent to that of the model. Moreover, the calibration curve showed that the risk predicted by the model and the score was in good agreement with the actual hypertension risk.

This accessible and practical correlation model and diagram can reliably identify older patients with OSAS at high risk of developing hypertension and facilitate solutions on modifying this risk most effectively.

The online version contains supplementary material available at 10.1007/s40520-025-02986-w.