High prevalence of hypertension in sleep apnea patients independent of obesity.

Carlson, Jan; Hedner, Jan; Ejnell, Hasse; Peterson, Lars-Erik

doi:10.1164/ajrccm.150.1.8025776

Cited by 188 publications

(99 citation statements)

References 22 publications

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“…The relationship between hypertension and OSAremains controversial (1)(2)(3)(4)(5). In the present study, blood pressures did not correlate with PSGparameters of the severity of OSA, suggesting that OSAis not directly related to hypertension.…”

Section: Discussioncontrasting

confidence: 66%

“…Although there is no direct evidence of an association between systemic hypertension and obstructive sleep apnea (OSA) (1)(2)(3)(4)(5), successful treatment of OSAimproves daytime hypertension, suggesting that there is a causal link between hypertension and OSA (6)(7)(8)(9). Wepreviously found that the application of short-term nasal continuous positive airway pressure (CPAP) reduces the daytime blood pressure in OSA patients (10).…”

Section: Introductionmentioning

confidence: 99%

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Acute Effects of Nasal Continuous Positive Airway Pressure on 24-Hour Blood Pressure and Catecholamines in Patients with Obstructive Sleep Apnea.

et al. 1998

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To assess the acute effects of nasal continuous positive airway pressure (CPAP) on the 24-hour blood pressure and the secretion of catecholamines in urine and plasma, we investigated the changes in the 24-hour blood pressure and urinary and plasma concentrations of epinephrine (E) and norepinephrine (NE) in 26 men with obstructive sleep apnea (OSA) with and without nasal CPAP. Nasal CPAPresulted in significant decreases in the daytime diastolic pressure (from 86 ± 16 mmHgto 83 ± 12 mmHg), the nighttime diastolic pressure (from 81 ± 12 mmHgto 77 ±9 mmHg) and the nighttime systolic pressures (from 125 ± 15 mmHgto 120 ± 10 mmHg). There was no significant difference between patients with and without CPAPin the daytime or nighttime urinary E level, but patients who received CPAPshowed a significant decrease in daytime urinary NElevel (from 156± 112 |ig/14h to 119 ± 101 |0g/14h) and nighttime urinary NE level (from 143 ±91 |ig/10h to 112 ± 65 |ig/10h). The morning plasma level of NE also decreased (from 371 ± 181 pg/ml to 273 ± 148 pg/ml) in patients who received nasal CPAP (p<0.02), but the plasma level of E remained unchanged. There were no correlations between PSGparameters and the reductions in blood pressure and the catecholamine levels induced by nasal CPAP.These findings suggest that OSA contributes, at least in part, to the development of systemic hypertension by increasing sympathetic nervous activity.

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Section: Discussioncontrasting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Acute Effects of Nasal Continuous Positive Airway Pressure on 24-Hour Blood Pressure and Catecholamines in Patients with Obstructive Sleep Apnea.

et al. 1998

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“…The mechanisms underlying the increased prevalence of cardiovascular diseases in OSAS [4,5] are unknown [3,6± 8]. To gain further insight into these mechanisms, the basal level of lipid peroxidation (TBARs content) and the oxidation susceptibility of isolated LDL particles (lag phase) in patients with untreated OSAS [18] was determined.…”

Section: Discussionmentioning

confidence: 99%

Abnormal lipid peroxidation in patients with sleep apnoea

Barceló¹,

Miralles²,

Barbé³

et al. 2000

Eur Respir J

210

114

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The prevalence of cardiovascular diseases is increased in patients with the obstructive sleep apnoea syndrome (OSAS). The fall and rise of arterial oxygenation that follows each apnoea may increase lipid peroxidation and contributes to explaining this association. In the present study, the authors determined lipid peroxidation in patients with OSAS and the effect of treatment with continuous positive airway pressure (CPAP).Fourteen male patients with severe OSAS (59 5 apnoea . h -1 ) ( SEM) and 13 healthy nonsmoking, male volunteers of similar age were studied. Patients were studied at diagnosis and after treatment with CPAP for more than 1 yr (>4 h . night -1 ). A venous blood sample was obtained early in the morning after fasting all night. In patients with OSAS, a sample before and during sleep was also obtained. Low density lipoprotein (LDL) particles were isolated by sequential ultracentrifugation. Their level of oxidation was determined by the thiobarbituric acid assay (TBARs), and their susceptibility to oxidation by the lag phase measurement.Patients with OSAS showed higher TBARs (28.1 2.8 versus 20.0 1.8 nmol . malondialdehyde . mgLDL protein -1 , p=0.02) and shorter lag phase values (83.8 3.4 versus 99.7 3.4 min, p=0.005) than controls. These differences were not due to the smoking status of the patient. Likewise, these values did not change significantly throughout the night yet, the lag phase value was significantly improved by treatment with CPAP (124.9 8.5 min; p<0.001).These results indicate that obstructive sleep apnoea syndrome is associated with abnormal lipid peroxidation and that this is improved by chronic use of Continuous positive airway pressure. These results can contribute towards explaining the high prevalence of cardiovascular diseases seen in Obstructive sleep apnoea syndrome.

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“…The condition has been reported to be associated with a significant morbidity and mortality, particularly related to cardiovascular diseases such as heart attack and stroke [2,3], although reports have provided different conclusions as to whether OSAS is an independent risk factor for these disorders over and above other potentially confounding variables [4±7]. However, patients with OSAS have been reported to be at increased risk of other diseases, which may also contribute to cardiovascular morbidity such as diabetes mellitus [8], thyroid disorders [9], and hypertension [10], in addition to having a high incidence of risk factors for cardiovascular disease such as obesity, hyperlipidaemia and male sex [11]. Therefore, it may become difficult to separate an independent cardiovascular risk of OSAS itself from that associated with these other comorbid factors.…”

mentioning

confidence: 99%

Cardiovascular risk factors in patients with obstructive sleep apnoea syndrome

Kiely¹,

McNicholas²

2000

Eur Respir J

164

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Cardiovascular disorders are common in patients with obstructive sleep apnoea syndrome (OSAS) but there is debate as to whether OSAS is an independent risk factor for their development, since OSAS may be associated with other disorders and risk factors that predispose to cardiovascular disease.In an effort to quantify the risk of OSAS patients for cardiovascular disease arising from these other factors, the authors assessed the future risk for cardiovascular disease among a group of 114 consecutive patients with established OSAS prior to nasal continuous positive airway pressure therapy, using an established method of risk prediction employed in the Framingham studies.Patients were 100 males, aged (meanSD) 529.0 yrs, and 14 females, aged 5110.4 yrs, with an apnoea/hypopnoea index of 4522 . h -1 . Based on either a prior diagnosis, or a mean of three resting blood pressure recordings >140 mmHg systolic and/or 90 diastolic, 68% of patients were hypertensive. Only 18% were current smokers, while 16% had either diabetes mellitus or impaired glucose tolerance, and 63% had elevated fasting cholesterol and/or triglyceride levels. The estimated 10-yr risk of a coronary heart disease (CHD) event in males was (meanSEM) 13.90.9%, 95% confidence interval (95% CI) 12.1±16.0, and for a stroke was 12.31.4%; 95% CI 9.4± 15.1, with a combined 10 yr risk for stroke and CHD events of 32.92.7%; 95% CI 27.8±38.5 in males aged >53 yrs.These findings indicate that obstructive sleep apnoea syndrome patients are at high risk of future cardiovascular disease from factors other than obstructive sleep apnoea syndrome, and may help explain the difficulties in identifying a potential independent risk from obstructive sleep apnoea syndrome.

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High prevalence of hypertension in sleep apnea patients independent of obesity.

Cited by 188 publications

References 22 publications

Acute Effects of Nasal Continuous Positive Airway Pressure on 24-Hour Blood Pressure and Catecholamines in Patients with Obstructive Sleep Apnea.

Acute Effects of Nasal Continuous Positive Airway Pressure on 24-Hour Blood Pressure and Catecholamines in Patients with Obstructive Sleep Apnea.

Abnormal lipid peroxidation in patients with sleep apnoea

Cardiovascular risk factors in patients with obstructive sleep apnoea syndrome

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