scholarly journals Circadian blood pressure rhythm and increased body weight in patients with arterial hypertension and obstructive sleep apnoea syndrome

2012 ◽  
Vol 11 (2) ◽  
pp. 24-28
Author(s):  
A. P. Ivanov ◽  
I. A. Elgardt ◽  
V. V. Rostorotskaya
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Obstructive Sleep Apnoea ◽  
Blood Pressure Monitoring ◽  
Fold Increase ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Obstructive Sleep ◽  
Electrocardiogram Ecg ◽  
Load Indices

Aim. To assess the specifics of 24-hour blood pressure monitoring (BPM) parameters and their association with body mass index (BMI) in patients with arterial hypertension (AH) and obstructive sleep apnoea (OSA) syndrome. Material and methods. The study included 120 AH patients with BMI under or over 25 kg/m2, who underwent 24-hour BMP and combined monitoring of electrocardiogram (ECG) and breathing. Results. AH patients with OSA syndrome demonstrated increased mean daytime and nighttime levels of systolic and diastolic BP (SBP, DBP) and a 1,5-fold increase in SBP and DBP pressure load indices. Patients with increased BMI had disturbed circadian BP profile, with reduced mean 24-hour difference, more pronounced for DBP (2,4-fold difference), and an increase in the “over-dipper” prevalence (from 13,3 % to 42,1 %). Conclusion. The combination of AH, OSA syndrome, and increased BMI substantially affected 24-hour BPM parameters. Increased BMI was associated with disturbed circadian BP profile and increased levels of mean 24-hour BP and nighttime BP

scholarly journals Blood pressure response to CPAP treatment in subjects with obstructive sleep apnoea: the predictive value of 24-h ambulatory blood pressure monitoring

2017 ◽  
Vol 50 (4) ◽  
pp. 1700651 ◽  
Author(s):  
Anabel L. Castro-Grattoni ◽  
Gerard Torres ◽  
Montserrat Martínez-Alonso ◽  
Ferran Barbé ◽  
Cecilia Turino ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Obstructive Sleep Apnoea ◽  
Blood Pressure Response ◽  
Blood Pressure Monitoring ◽  
Sleep Apnoea ◽  
Clinical Predictors ◽  
Night Time ◽  
Nocturnal Hypertension ◽  
Obstructive Sleep

The reduction in blood pressure (BP) with continuous positive airway pressure (CPAP) is modest and highly variable. In this study, we identified the variables that predict BP response to CPAP.24-h ambulatory BP monitoring (ABPM), C-reactive protein (CRP), leptin, adiponectin and 24-h urinary catecholamine were measured before and after 6 months of CPAP in obstructive sleep apnoea (OSA) patients.Overall, 88 middle-aged, obese male patients with severe OSA (median apnoea–hypopnoea index 42 events·h−1) were included; 28.4% had hypertension. 62 patients finished the study, and 60 were analysed. The daytime diastolic BP (−2 mmHg) and norepinephrine (−109.5 nmol·day-1) were reduced after CPAP, but no changes in the 24-h BP, night-time BP, dopamine, epinephrine, CRP, leptin or adiponectin were detected. The nocturnal normotension was associated with an increased night-time-BP (+4 mmHg) after CPAP, whereas nocturnal hypertension was associated with a reduction of 24-h BP (−3 mmHg). A multivariate linear regression model showed differential night-time BP changes after CPAP. Specifically, low night-time heart rate (<68 bpm) and BP dipper profile were associated with increased night-time BP and new diagnosis of nocturnal hypertension.Our results suggest that nocturnal hypertension, circadian BP pattern and night-time heart rate could be clinical predictors of BP response to CPAP and support the usefulness of 24-h ABPM for OSA patients before treatment initiation. These results need to be confirmed in further studies.

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