Association of obstructive sleep apnea with arterial stiffness and nondipping blood pressure in patients with hypertension

• Published in: The journal of clinical hypertension (Greenwich, Conn.) Vol. 19; no. 9; pp. 910 - 918
• Main Authors: Jenner, Raimundo, Fatureto‐Borges, Fernanda, Costa‐Hong, Valéria, Lopes, Heno F., Teixeira, Sandra H., Marum, Elias, Giorgi, Dante A. M., Consolim‐Colombo, Fernanda M., Bortolotto, Luiz A., Lorenzi‐Filho, Geraldo, Krieger, Eduardo M., Drager, Luciano F.
• Format: Journal Article
• Language: English
• Published: United States John Wiley and Sons Inc 01-09-2017
• Subjects: Adult; Aged; Angiotensin II Type 1 Receptor Blockers - therapeutic use; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; arterial stiffness; blood pressure; Blood Pressure - physiology; Blood Pressure Monitoring, Ambulatory - methods; Brazil - epidemiology; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - physiopathology; Diuretics - standards; Diuretics - therapeutic use; Echocardiography - methods; Enalapril - administration & dosage; Enalapril - therapeutic use; Female; Humans; Hydrochlorothiazide - administration & dosage; Hydrochlorothiazide - standards; Hydrochlorothiazide - therapeutic use; Hypertension - complications; Hypertension - drug therapy; Hypertension - epidemiology; Hypertension - physiopathology; Losartan - administration & dosage; Losartan - therapeutic use; Male; Middle Aged; Original Paper; Polysomnography - methods; Pulse Wave Analysis - methods; Risk Factors; sex; sleep apnea; Sleep Apnea and Hypertension; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - epidemiology; Sleep Apnea, Obstructive - physiopathology; Vascular Stiffness - physiology; arterial stiffness; blood pressure; sleep apnea; sex
• ISSN: 1524-6175; 1751-7176
• DOI: 10.1111/jch.13008

Whether sex influences the association of obstructive sleep apnea (OSA) with markers of cardiovascular risk in patients with hypertension is unknown. In this study, 95 hypertensive participants underwent carotid‐femoral pulse wave velocity, 24‐hour ambulatory blood pressure monitoring, echocardiogram, and polysomnography after a 30‐day standardized treatment with hydrochlorothiazide plus enalapril or losartan. OSA was present in 52 patients. Compared with non‐OSA patients, pulse wave velocity values were higher in the OSA group (men: 11.1±2.2 vs 12.7±2.4 m/s, P=.04; women: 11.8±2.4 vs 13.2±2.2 m/s, P=.03). The proportion of diastolic dysfunction was significant in men and women with OSA. Compared with non‐OSA patients, nondipping systolic blood pressure in OSA was higher in men (14.3% vs 46.4%) and in women (41.4% vs 65.2%). OSA was independently associated with pulse wave velocity (β=1.050; P=.025) and nondipping systolic blood pressure (odds ratio, 3.03; 95% confidence interval, 1.08–8.55; P=.035) in the regression analysis. In conclusion, OSA is independently associated with arterial stiffness and nondipping blood pressure in patients with hypertension regardless of sex.