@article {Roche649, author = {Fr{\'e}d{\'e}ric Roche and Jean-Louis P{\'e}pin and Emilie Achour-Crawford and Renaud Tamisier and Vincent Pichot and S{\'e}bastien Celle and Delphine Maudoux and Florian Chouchou and Hourfil G. Ntougou-Assoumou and Patrick L{\'e}vy and Jean Claude Barth{\'e}l{\'e}my}, title = {At 68 years, unrecognised sleep apnoea is associated with elevated ambulatory blood pressure}, volume = {40}, number = {3}, pages = {649--656}, year = {2012}, doi = {10.1183/09031936.00162710}, publisher = {European Respiratory Society}, abstract = {After the age of 65 yrs the specific impact of unrecognised sleep-related breathing disorders (SRBD) on 24-h blood pressure (BP) levels remains under debate. We tested the cross-sectional relationship between the severity of obstructive sleep apnoea/hypopnoea (OSAH) and the increase of BP using ambulatory BP monitoring (ABPM) in the PROOF (PROgnostic indicator OF cardiovascular and cerebrovascular events study)-SYNAPSE (Autonomic Nervous System Activity, Aging and Sleep Apnea/Hypopnea study) cohort. 470 subjects (aged 68 yrs) neither treated for hypertension nor diagnosed for SRBD were included. All subjects underwent ABPM, and unattended at-home polygraphic studies. OSAH was defined by an apnoea/hypopnoea index (AHI) \>15{\textperiodcentered}h-1. The severity of the sleep apnoea was also quantified as the index of dips in oxyhaemoglobin saturation \>3\% (ODI). Results are expressed in per protocol analysis. Severe OSAH (AHI \>30{\textperiodcentered}h-1, 17\% of subjects) was associated with a significant 5 mmHg increase in both diurnal and nocturnal systolic BP (SBP), and with a nocturnal 3 mmHg increase in diastolic BP (DBP). Systolic (mean SBP \>135 mmHg) or diastolic (mean DBP \>80 mmHg) hypertension were more frequently encountered in subjects suffering from moderate (AHI 15{\textendash}30) or severe OSAH. After adjustment, the independent association between severe OSAH and 24-h systolic hypertension remained significant (OR 2.42, 95\% CI 1.1{\textendash}5.4). The relationship was further reinforced when SRBD severity was expressed using ODI \>10{\textperiodcentered}h-1. The impact of unrecognised SRBD on BP levels also exists at the age of 68 yrs. The hypoxaemic load appears to be the pathophysiological cornerstone for such a relationship.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/40/3/649}, eprint = {https://erj.ersjournals.com/content/40/3/649.full.pdf}, journal = {European Respiratory Journal} }