Risk of Hypertension and Mortality Among People With Narcolepsy or Idiopathic Hypersomnia: A Retrospective Cohort Analysis of the Danish National Patient Registry

ABSTRACT

To assess the prevalence of hypertension, risk of developing hypertension, and risk of mortality among individuals with narcolepsy or idiopathic hypersomnia in Denmark, we performed a retrospective, nationwide, cohort analysis of the Danish National Patient Registry (DNPR). Adults (aged ≥ 18 years) diagnosed with narcolepsy or idiopathic hypersomnia between 1 January 1998 and 31 December 2020 were matched 1:4 with non‐narcolepsy/non‐idiopathic hypersomnia controls based on key demographics (age, sex, marital status, geographic location). Outcomes included hypertension prevalence at diagnosis, incident hypertension after diagnosis, and mortality risk. For individuals with narcolepsy ( n  = 1760) versus matched controls ( n  = 7012), the odds ratio (OR) for having prevalent hypertension at diagnosis was 1.50 (95% confidence interval [CI], 1.28–1.76); individuals with narcolepsy also had higher risk (hazard ratio [HR; 95% CI]) of developing hypertension after diagnosis (1.40 [1.23–1.60]) and of mortality (1.25 [1.08–1.44]). Individuals with idiopathic hypersomnia ( n  = 3067) versus matched controls ( n  = 12,241) had higher odds (OR [95% CI]) of having prevalent hypertension at diagnosis (1.84 [1.64–2.05]) and higher risk (HR [95% CI]) of developing hypertension after diagnosis (1.38 [1.28–1.50]); mortality risk was similar for idiopathic hypersomnia versus controls (HR [95% CI]: 0.94 [0.84–1.06]). These data provide one of the first DNPR examinations of cardiovascular burden and mortality in individuals with idiopathic hypersomnia, finding greater prevalence and risk of developing hypertension in people with narcolepsy or idiopathic hypersomnia compared with matched controls. Mortality risk was also higher in people with narcolepsy. Findings support that the cardiovascular burden experienced by these populations should be considered during treatment evaluation. Please find the file attached for your reference.