Blood pressure levels and hypertension prevalence in acromegalic patients with obstructive sleep apnoe

Background. Hypertension (HTN) is an independent factor of cardiovascular morbidity in acromegalic patients. Obstructive sleep disordered breathing (SDB) is the most common respiratory impairment in acromegaly and is considered one of the mechanisms underlying the development of HTN in acromegaly.

Objective. Тo assess blood pressure (BP) parameters and prevalence of HTN in naive acromegalic patients depending on the presence of moderate-to-severe SDB.

Design and methods. Forty-eight naive acromegalic patients [11 men, 37 women, median age 53,5 (27–76) years] were recruited into the study. All subjects underwent clinical examination including office BP measurement, full polysomnography, twenty-four-hour BP monitoring (24‑hour BPM).

Results. SDB, namely obstructive sleep apnea (OSA), was found in 36 (75%) patients. Thirteen patients (36%) had mild, eleven (31%) — moderate and twelve (33%) showed severe OSA. The latter two groups (moderate-to-severe OSA, further referred as patients with OSA) were compared to patients without OSA (non-OSA). In patients with OSA office diastolic BP was significantly higher than in patients without OSA (р < 0,03). According to 24‑hour BPM mean 24‑hour, daytime and nighttime BP levels were significantly higher in patients with OSA as compared to non-OSA subjects. The rate of elevated office (χ² = 3,85; р < 0,05), mean 24‑hour (χ² = 4,8; р = 0,03) and nighttime BP (χ² = 5,23; р < 0,03) was significantly higher in OSA group, while the frequency of daytime HTN was similar in both groups.

Conclusions. According to the office measurement and 24‑hour BPM the BP parameters and HTN prevalence were higher in patients with OSA. According to our data, a polysomnography study should be recommended in patients with newly diagnosed acromegaly in order to detect ones at higher risk of HTN development

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