The incremental effect of obstructive sleep apnoea syndrome on arterial stiffness in newly diagnosed essential hypertensive subjects
- 1 January 2007
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Hypertension
- Vol. 25 (1), 141-146
- https://doi.org/10.1097/hjh.0b013e32801092c1
Abstract
Although obstructive sleep apnoea syndrome (OSAS) is accompanied by an increased atherosclerotic cardiovascular disease burden, its relationship with arterial stiffness is not yet well determined. We investigated whether essential hypertensive individuals with OSAS are characterized by increased arterial stiffness. Our study population consisted of 46 consecutive patients with newly diagnosed untreated stage I-II essential hypertension suffering from OSAS (35 men, aged 49 +/- 8 years) and 53 hypertensive individuals without OSAS, matched for age, sex, and smoking status. All subjects underwent polysomnography, echocardiography and aortic stiffness evaluation by means of carotid-femoral pulse wave velocity (c-fPWV) measurements. Hypertensive subjects with OSAS [apnoea/hypopnoea index (AHI)>or =5] compared with hypertensive subjects without OSAS (AHI < 5) demonstrated increased levels of body mass index (31.4 +/- 4 versus 29.3 +/- 4 kg/m2, P = 0.015), office systolic/diastolic blood pressure (151/99 versus 145/94 mmHg, respectively, P < 0.05, for both cases) and relative wall thickness (RWT; 0.46 +/- 0.06 versus 0.42 +/- 0.07, P=0.010). Hypertensive subjects with OSAS compared with those without OSAS had significantly increased c-fPWV by 9% (8.56 +/- 0.49 versus 7.85 +/- 0.93 m/s, P=0.001) and this difference remained significant even after adjustment for confounders (P=0.04). In the total study population, c-fPWV was correlated with age (r=0.35, P=0.015), office systolic blood pressure (r=0.30, P=0.007), RWT (r=0.30, P=0.03), logAHI (r=0.389, P=0.0001) and minimum oxygen saturation (r=-0.418, P=0.0001). OSAS has a significant incremental effect on aortic stiffening in the setting of middle-aged essential hypertensive subjects. This finding suggests that the presence of OSAS in a hypertensive patient accelerates vascular damage, increasing cardiovascular risk.Keywords
This publication has 35 references indexed in Scilit:
- Arterial Stiffness, Wave Reflections, and the Risk of Coronary Artery DiseaseCirculation, 2004
- 2003 European Society of Hypertension???European Society of Cardiology guidelines for the management of arterial hypertension*Journal Of Hypertension, 2003
- The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood PressureThe JNC 7 ReportJama-Journal Of The American Medical Association, 2003
- Aortic Stiffness Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Hypertensive PatientsHypertension, 2001
- Increased vasoconstrictor sensitivity in obstructive sleep apneaJournal of Applied Physiology, 2000
- Prospective Study of the Association between Sleep-Disordered Breathing and HypertensionNew England Journal of Medicine, 2000
- Association of Sleep-Disordered Breathing, Sleep Apnea, and Hypertension in a Large Community-Based StudyJama-Journal Of The American Medical Association, 2000
- Sleep–Related Breathing Disorders in Adults: Recommendations for Syndrome Definition and Measurement Techniques in Clinical ResearchSleep, 1999
- Impact of Aortic Stiffness on Survival in End-Stage Renal DiseaseCirculation, 1999
- Aortic Pulse Wave Velocity as a Marker of Cardiovascular Risk in Hypertensive PatientsHypertension, 1999