THE ROLE OF OBSTRUCTIVE SLEEP APNEA SYNDROME IN MASKED HYPERTENSION
https://doi.org/10.18705/1607-419X-2013-19-6-525-531
Abstract
Objective. To assess office and outpatient blood pressure (BP) in patients with the persistent and masked hypertension (HTN) and obstructive sleep apnea syndrome (OSAS).
Design and methods. We enrolled 121 subjects with BP increase and verified OSAS by multifunctional monitoring including registration of electrocardiogram, BP and respiration (Кardiotekhnika 04-BP3 (M), St Petersburg, Russia) that were divided into 2 groups: patients with stable and masked HTN.
Results. The groups differed by age, office and ambulatory BP in subjects younger 40 years. Males were prevalent among patients with OSAS and masked HTN. Smoking rate was also higher in this group. Both daytime and nocturnal BP were higher in subjects with OSAS and masked HTN. According to multiple regression analysis there were several predictors of masked HTN in OSAS patients: male gender, high normal BP, smoking and BP elevation at night.
Conclusions. Multifunctional monitoring with the registration of BP and respiration is obligatory in patients with HTN and suspected sleep breathing disorders in order to diagnose latent HTN.
About the Authors
A. P. Ivanov
Tver State Medical Academy, Tver.
Tver Regional Cardiology Clinic, Tver
Russian Federation
Russian Federation
Corresponding author: Tver Regional Cardiology Clinic, 19 Komsomolskiy av., Tver, Russia, 170041. Phone: +7 (4822) 52–05–05. Fax: +7 (4822) 52–84–21. Е-mail: ivanovcardio2010@yandex.ru (Alexander P. Ivanov, MD, PhD, Professor at the Department for Internal Diseases of the Faculty of Advanced Training at Tver State Medical Academy, the Head of Tver Regional Cardiology Clinic).
K. A. Maltsev
Tver Regional Cardiology Clinic, Tver
Russian Federation
Russian Federation
I. A. Elgardt
Tver Regional Cardiology Clinic, Tver
Russian Federation
Russian Federation
N. S. Sdobnyakova
Tver Regional Cardiology Clinic, Tver
Russian Federation
Russian Federation
References
1. Lattimore J.D., Celermajer D.S., Wilcox I. Obstructive sleep apnea and cardiovascular disease // J. Am. Coll. Cardiol. — 2003. — Vol. 41, № 9. — P. 429–437.
2. Davis C.W., Crosby J.H., Mullins R.L., Barbour C., Davies R.J., Stradling J.R. Case-control study of 24 hour ambulatory blood pressure in patients with obstructive sleep apnea and normal matches control subjects // Thorax. — 2000. — Vol. 55, № 9. — P. 736–740.
3. Hedner J., Bengtsson-Bostroom K., Peker Y., Grote L., Råstam L., Lindblad U. Hypertension prevalence in obstructive sleep apnea and sex: a population-based case-control study // Eur. Respir. J. — 2006. — Vol. 27, № 3. — P. 1–7.
4. Wright J.T., Redline S., Taylor A.L. et al. Relationship between 24-h blood pressure and sleep disordered breathing in a normotensive community sample // Am. J. Hypertens. — 2001. — Vol. 14, № 8, Pt. 1. — P. 743–748.
5. Dhillon S., Chung S.A., Fargher T. et al. Sleep apnea, hypertension, and the effects of continuous positive airway pressure. / Am. J. Hypertens. — 2005. — Vol. 18. — P. 594–600.
6. Baguet J.P., Hammer L., Levy P. et al. Night-time and diastolic hypertension are common and underestimated conditions in newly diagnosed apnoetic patients // J. Hypertens. — 2005. — Vol. 23, № 3. — P. 521–527.
7. Sega R., Trocino G., Lanzarotti A. et al. Alterations of cardiac structure in patients with isolated office, ambulatory, or home hypertension: data from the general population (Pressione Arteriose Monitorate E Logo Associazion [PAMELA] Study) // Circulation. — 2001. — Vol. 104, № 12. — P. 1385–1392.
8. Tomiyama M., Horio T., Yoshii M. et al. Masked hypertension and target organ damage in treated hypertensive patients // Am. J. Hypertens. — 2006. — Vol. 19, № 9. — P. 880–886.
9. Диагностика и лечение артериальной гипертензии. Российские рекомендации (четвертый пересмотр). — М., 2010. — 34 с. / Diagnostics and treatment of arterial hypertension. Russian guide- . / Diagnostics and treatment of arterial hypertension. Russian guidelines (the fourth revision). — Moscow, 2010. — 34 p. [Russian].
10. Bradley T.D., Floras J.S. Obstructive sleep apnoea and its cardiovascular consequences // Lancet. — 2009. — Vol. 373, № 9657. — P. 82–93.
11. Chobanian A.V., Bakris G.L., Black H.R. et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 report // J. Am. Med. Assoc. — 2003. — Vol. 289, № 19. — P. 2560–2572.
12. Devereux R.B., Pickering T.G. Ambulatory blood pressure in assessing the cardiac impact and prognosis of hypertension / In: O`Brien E., O`Malley K., editors. Blood pressure measurement. — Amsterdam: Elsevier, 1991. — P. 261–285.
13. Bobrie G., Trocino G., Lanzalotti A. et al. Cardiovascular prognosis of ‘masked hypertension’ detected by blood pressure self-measurement in elderly treated hypertensive patients // J. Am. Med. Assoc. — 2004. — Vol. 291. — P. 1342–1249.
14. Ben-Dov I.Z., Ben-Arie L., Mekler J. et al. In clinical practice, masked hypertension is as common as isolated clinical hypertension: predominance of younger men // Am. J. Hypertens. — 2005. — Vol. 18, № 5, Pt. 1. — P. 589–593.
15. O`Brien E., Asmar R., Beilin L. et al. European Society of Hypertension recommendation for conventional, ambulatory and home blood pressure measurement // J. Hypertens. — 2003. — Vol. 21, № 5. — P. 821–848.
16. Мамонтов О.В., Свиряев Ю.В., Киталаева К.Т. и др. Особенности автономной регуляции кровообращения у больных артериальной гипертензией с синдромом обструктивного апноэ/гипопноэ во сне // Артериальная гипертензия. — 2012. — Т. 18, № 6. — С. 560–568. / Mamontov O.V., Sviryaev Yu.V., Kitalaeva K.T. et al. Autonomic regulation of circulation in hypertensive patients with obstructive sleep apnea syndrome // Arterial Hypertension [Arterialnaya Gipertenziya]. — 2012. — Vol. 18, № 6. — Р. 560–568 [Russian].
17. Казидаева Е.Н., Веневцева Ю.Л. Взаимосвязь показателей полифункционального мониторирования у молодых людей с прегипертензией или мягкой артериальной гипертензией, имеющих разный суточный профиль артериального давления // Артериальная гипертензия. — 2013. — Т. 19, № 1. — С. 44–50. / Kazidaeva E.N., Venevtseva Yu.L. Interrelation between polyfunctional monitoring data in young men with pre- or mild hypertension with different blood pressure daily profile // Arterial Hypertension [Arterialnaya Gipertenziya]. — 2013. — Vol. 19, № 1. — Р. 44–50 [Russian].
Review
For citations:
Ivanov A.P., Maltsev K.A., Elgardt I.A., Sdobnyakova N.S. THE ROLE OF OBSTRUCTIVE SLEEP APNEA SYNDROME IN MASKED HYPERTENSION. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2013;19(6):525-531. (In Russ.) https://doi.org/10.18705/1607-419X-2013-19-6-525-531
Views:
1166
Email this article 