RT Journal Article
SR Electronic
T1 At 68 yrs, unrecognized sleep apnoea is associated with elevated ambulatory blood pressure
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj01627-2010
DO 10.1183/09031936.00162710
A1 F. Roche
A1 J-L. Pépin
A1 E. Achour-Crawford
A1 R. Tamisier
A1 V. Pichot
A1 S. Celle
A1 D. Maudoux
A1 F. Chouchou
A1 H.G.N. Assoumou
A1 P. Lévy
A1 J.C. Barthélémy
A1 for The PROOF Study Group
YR 2012
UL http://erj.ersjournals.com/content/early/2012/04/19/09031936.00162710.abstract
AB After 65 years old, the specific impact of unrecognized sleep-related breathing disorders (SRBD) on 24-hour blood pressure (BP) levels remains still debated. We tested the cross-sectional relationship between the severity of obstructive sleep apnoea/hypopnoea (OSAH) and the increase of BP measured with an ambulatory BP monitoring in the PROOF-SYNAPSE cohort.470 subjects (age: 68 years) neither treated for hypertension nor diagnosed for SRBD were included. They all underwent ambulatory blood pressure monitoring, (ABP) and unattended at-home polygraphic studies. OSAH was defined by an apnoea plus hypopnoea index (AHI) above 15·hour−1. The severity of sleep apnoea was also quantified as the index of dips in oxyhemoglobin saturation > 3% (ODI). Results are expressed in per- protocol analysis.Severe OSAH (AHI>30·h−1, 17% of subjects) was associated with a significant 5 mmHg increase in both diurnal and nocturnal Systolic BP, and with a nocturnal 3 mmHg increase in Diastolic BP. Systolic (mean SBP>135 mmHg) or diastolic (mean DBP>80 mmHg) hypertension were more frequently encountered in subjects suffering from moderate (AHI:15–30) or severe OSAH. After adjustment, the independant association between severe OSAH and 24-hour systolic hypertension remained significant (OR 2.42; CI[1.1–5.4]). The relationship was further reinforced when SRBD severity was expressed using ODI>10·h−1.The impact of unrecognized SRBD on blood pressure levels also exists at 68 years old. The hypoxemic load appears the pathophysiological cornerstone for such a relationship.