Influence of sleep apnea severity on blood pressure variability of patients with hypertension

Influence of sleep apnea severity on blood pressure variability of patients with hypertension

Purpose Obstructive sleep apnea (OSA) is a risk factor for the development of hypertension and cardiovascular disease. Apnea overloads the autonomic cardiovascular control system and may influence blood pressure variability, a risk for vascular damage independent of blood pressure levels. This study...

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Bibliographic Details
Published in:Sleep & breathing Vol. 18; no. 2; pp. 397 - 401
Main Authors: Steinhorst, Ana P., Gonçalves, Sandro C., Oliveira, Ana T., Massierer, Daniela, Gus, Miguel, Fuchs, Sandra C., Moreira, Leila B., Martinez, Denis, Fuchs, Flávio D.
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-05-2014
Springer
Springer Nature B.V
Subjects:
Adult
Aged
Arterial hypertension. Arterial hypotension
Autonomic Nervous System - physiopathology
Biological and medical sciences
Blood and lymphatic vessels
Blood pressure
Blood Pressure - physiology
Blood Pressure Monitoring, Ambulatory
Cardiology. Vascular system
Cardiovascular System - innervation
Circadian Rhythm - physiology
Cross-Sectional Studies
Dentistry
Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes
Female
Fundamental and applied biological sciences. Psychology
Humans
Hypertension
Hypertension - diagnosis
Hypertension - physiopathology
Internal Medicine
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Nervous system (semeiology, syndromes)
Neurology
Original Article
Otorhinolaryngology
Pediatrics
Pneumology
Pneumology/Respiratory System
Reference Values
Respiratory system : syndromes and miscellaneous diseases
Risk Factors
Sleep apnea
Sleep Apnea, Obstructive - diagnosis
Sleep Apnea, Obstructive - physiopathology
Sleep. Vigilance
Vertebrates: nervous system and sense organs
Hypertension
Blood pressure variability
Sleep apnea
Apnea–hypopnea index
Human
Nervous system diseases
Sleep apnea syndrome
Respiratory disease
Variability
Apnea-hypopnea index
Sleep disorder
Cardiovascular disease
Apnea
Sleep
Arterial pressure
Blood pressure
Sleep wake cycle
Hemodynamics
Neurological disorder
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Summary:Purpose Obstructive sleep apnea (OSA) is a risk factor for the development of hypertension and cardiovascular disease. Apnea overloads the autonomic cardiovascular control system and may influence blood pressure variability, a risk for vascular damage independent of blood pressure levels. This study investigates the hypothesis that blood pressure variability is associated with OSA. Methods In a cross-sectional study, 107 patients with hypertension underwent 24-h ambulatory blood pressure monitoring and level III polysomnography to detect sleep apnea. Pressure variability was assessed by the first derivative of blood pressure over time, the time rate index, and by the standard deviation of blood pressure measurements. The association between the apnea–hypopnea index and blood pressure variability was tested by univariate and multivariate methods. Results The 57 patients with apnea were older, had higher blood pressure, and had longer duration of hypertension than the 50 patients without apnea. Patients with apnea–hypopnea index (AHI) ≥ 10 had higher blood pressure variability assessed by the standard deviation than patients with AHI < 10 during sleep (10.4 ± 0.7 versus 8.0 ± 0.7, P  = 0.02) after adjustment for age, body mass, and blood pressure. Blood pressure variability assessed by the time rate index presented a trend for association during sleep ( P  = 0.07). Daytime blood pressure variability was not associated with the severity of sleep apnea. Conclusion Sleep apnea increases nighttime blood pressure variability in patients with hypertension and may be another pathway linking sleep abnormalities to cardiovascular disease.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1520-9512
1522-1709
DOI:10.1007/s11325-013-0899-z