Diurnal changes in central blood pressure and pulse pressure amplification in patients with obstructive sleep apnoea

OSA (obstructive sleep apnoea) stimulates sympathetic nervous activity and elevates resting HR (heart rate) and BP (blood pressure). In the present study in a cohort of 309 untreated OSA patients, the resting HR and BP during the daytime were correlated with AHI (apnoea/hypopnea index) and compared with patients with R389R (n=162), R389G (n=125) and G389G (n=22) genotypes of the β1-adrenoreceptor R389G polymorphism. We analysed the impact of the genotype on the decline of HR and BP in a subgroup of 148 patients (R389R, n=86; R389G, n=54; G389G, n=8) during a 6-month follow-up period under CPAP (continuous positive airway pressure) therapy during which cardiovascular medication remained unchanged. In untreated OSA patients, we found an independent relationship between AHI and resting HR (β=0.096, P<0.001), systolic BP (β=0.09, P=0.021) and diastolic BP (β=0.059, P=0.016). The resting HR/BP, however, did not differ among carriers with the R389R, R389G and G389G genotypes. CPAP therapy significantly reduced HR [−2.5 (−1.1 to −4.0) beats/min; values are mean difference (95% confidence intervals)] and diastolic BP [−3.2 (−1.5 to −5.0) mmHg]. The decline in HR was more significantly pronounced in the R389R group compared with the Gly389 carriers [−4.1 (−2.3 to −5.9) beats/min (P<0.001) compared with −0.2 (2.1 to −2.6) beats/min (P=0.854) respectively; Student's t test between groups, P=0.008]. Diastolic BP was decreased significantly (P<0.001) only in Gly389 carriers (R389G or G389G) compared with R389R carriers [−5.0 (−2.3 to −7.6) mmHg compared with −2.0 (0.4 to −4.3) mmHg respectively]. ANOVA revealed a significant difference (P=0.023) in HR reduction between the three genotypes [−4.1 (±8.4) beats/min for R389R, −0.5 (±9.3) beats/min for R389G and +1.9 (±7.2) beats/min for G389G]. In conclusion, although the R389G polymorphism of the β1-adrenoceptor gene did not influence resting HR or BP in untreated OSA patients, it may modify the beneficial effects of CPAP therapy on these parameters.

Download Full-text

Effects of continuous positive airway pressure on blood pressure in hypertensive patients with obstructive sleep apnoea

Journal of Hypertension ◽

10.1097/hjh.0000000000000377 ◽

2014 ◽

Vol 32 (11) ◽

pp. 2279-2280

Author(s):

Alexandros Kasiakogias ◽

Costas Tsioufis ◽

Costas Thomopoulos ◽

Dimitrios Tousoulis

Keyword(s):

Blood Pressure ◽

Continuous Positive Airway Pressure ◽

Obstructive Sleep Apnoea ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Sleep Apnoea ◽

Hypertensive Patients ◽

Obstructive Sleep

Download Full-text

Case-control study of 24 hour ambulatory blood pressure in patients with obstructive sleep apnoea and normal matched control subjects

Thorax ◽

10.1136/thorax.55.9.736 ◽

2000 ◽

Vol 55 (9) ◽

pp. 736-740 ◽

Cited By ~ 139

Author(s):

C. W H Davies

Keyword(s):

Blood Pressure ◽

Obstructive Sleep Apnoea ◽

Ambulatory Blood Pressure ◽

Case Control Study ◽

Matched Control ◽

Case Control ◽

Sleep Apnoea ◽

Control Subjects ◽

Obstructive Sleep ◽

Control Study

Download Full-text

Does obstructive sleep apnoea contribute to obesity, hypertension and kidney dysfunction in children? A systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2020-039342 ◽

2020 ◽

Vol 10 (8) ◽

pp. e039342

Author(s):

Sara Rodriguez-Lopez ◽

Stefan Palkowski ◽

Christopher Gerdung ◽

Diana Keto-Lambert ◽

Meghan Sebastianski ◽

...

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Kidney Function ◽

Obstructive Sleep Apnoea ◽

Systemic Blood Pressure ◽

Sleep Apnoea ◽

Cochrane Library ◽

Systemic Blood ◽

Obstructive Sleep ◽

Obesity Hypertension

IntroductionChildhood obstructive sleep apnoea (OSA) is a highly prevalent disorder that may directly contribute to the development of obesity, hypertension and renal injury. Although those associations seem to be clearer in adults, studies in children have revealed conflicting results and updated synthesis of the evidence is lacking. The aim of this systematic review is to summarise the available evidence on the effect of OSA on obesity, systemic blood pressure and kidney function, to help to elucidate whether respiratory interventions to correct OSA would have the potential to improve those outcomes.Methods and analysisA systematic literature review search was created by a medical librarian and peer-reviewed by a second librarian prior to running. Ovid Medline, Ovid Embase, CINAHL via EbscoHOST, Wiley Cochrane Library and ProQuest Dissertations and Theses Global were searched on 25 February 2020. Titles and abstracts will be screened by two independent reviewers for inclusion, followed by full-text screening of relevant articles. Studies in children will be included if they report data on OSA and weight, systemic blood pressure or kidney parameters. The extracted data will be combined for analysis and the information subcategorised in groups based on outcome. Risk of bias will be determined using tools specific to study methodology and certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations approach.Ethics and disseminationThis study will provide essential information for healthcare professionals to better understand the relationship between childhood OSA and changes in body mass index, systemic blood pressure and kidney function indicators. Our findings will be disseminated through conferences and publications. The results of this review may guide the initiation of new strategies and the development of future research studies. This research did not involve human subjects and therefore did not undergo research ethical review.PROSPERO registration numberCRD42020171186.

Download Full-text