Relationship between Hypertension and Obstructive Sleep Apnea
Background: The strong association between obstructive sleep apnea syndrome (OSAS) and systemic hypertension is well recognized in some epidemiological researches. Objective: To analyze the relationship between hypertension and obstructive sleep apnea. Methods: All hypertensive patients (n=25) who w...
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| Published in | Japanese Journal of National Medical Services Vol. 62; no. 5; pp. 270 - 274 |
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| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japanese Society of National Medical Services
20.05.2008
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-1699 1884-8729 |
| DOI | 10.11261/iryo1946.62.270 |
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| Abstract | Background: The strong association between obstructive sleep apnea syndrome (OSAS) and systemic hypertension is well recognized in some epidemiological researches. Objective: To analyze the relationship between hypertension and obstructive sleep apnea. Methods: All hypertensive patients (n=25) who were BMI>25kg/m2 or had heavy snoring or excessive daytime sleepiness were examined with polysomnography (PSG). These subjects were classified according to data of apnea and hypopnea index (AHI). AHI was calculated as the total number of episodes of apnea and hypopnea per hour of sleep. An AHI≥5 to<20 indicated mild OSAS, 20≤to<40 indicated moderate OSAS, and≥40 indicated severe OSAS. These groups were then compared in terms of age, BMI, number of antihypertensive drugs used, blood pressure (BP) at out-patient clinic, lowest SaO2, mean SaO2, creatinine, uric acid, and lipids. PSG revealed all hypertensive patients (malel5, female10) to be OSAS patients (AHI>5). Patients (n=13) with moderate to severe OSAS (AHI>30/hr) were treated with nCPAP. 4 weeks after nCPAP was begun, blood pressure was measured between 10:00-12:00a.m. at our outpatient clinic. Results: AHI was strongly associated with mean SaO2 and systolic BP. There was a significant positive relationship between medications for hypertension and AHI (r=0.46, P<0.05). After nCPAP treatment for 4 weeks, systolic BP was significantly reduced from 139.4±18.3mmHg to 120.9±7.7mmHg (P<0.05). Our results demonstrate that nCPAP is useful for lowering blood pressure in such patients with drug-resistant hypertension and OSAS. |
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| AbstractList | Background: The strong association between obstructive sleep apnea syndrome (OSAS) and systemic hypertension is well recognized in some epidemiological researches. Objective: To analyze the relationship between hypertension and obstructive sleep apnea. Methods: All hypertensive patients (n=25) who were BMI>25kg/m2 or had heavy snoring or excessive daytime sleepiness were examined with polysomnography (PSG). These subjects were classified according to data of apnea and hypopnea index (AHI). AHI was calculated as the total number of episodes of apnea and hypopnea per hour of sleep. An AHI≥5 to<20 indicated mild OSAS, 20≤to<40 indicated moderate OSAS, and≥40 indicated severe OSAS. These groups were then compared in terms of age, BMI, number of antihypertensive drugs used, blood pressure (BP) at out-patient clinic, lowest SaO2, mean SaO2, creatinine, uric acid, and lipids. PSG revealed all hypertensive patients (malel5, female10) to be OSAS patients (AHI>5). Patients (n=13) with moderate to severe OSAS (AHI>30/hr) were treated with nCPAP. 4 weeks after nCPAP was begun, blood pressure was measured between 10:00-12:00a.m. at our outpatient clinic. Results: AHI was strongly associated with mean SaO2 and systolic BP. There was a significant positive relationship between medications for hypertension and AHI (r=0.46, P<0.05). After nCPAP treatment for 4 weeks, systolic BP was significantly reduced from 139.4±18.3mmHg to 120.9±7.7mmHg (P<0.05). Our results demonstrate that nCPAP is useful for lowering blood pressure in such patients with drug-resistant hypertension and OSAS. |
| Author | TOMODA, Jun IKEDA, Masae TAKEMOTO, Syunji KAJIKAWA, Yutaka |
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| References | 12) Minemura H, Akashiba T, Yamamoto H et al. Acute effects of nasal continuous positive airway pressure on 24-hour blood pressure and catecholamines in patients with obstructive sleep apnea. Intern Med 1998; 37: 1009-13. 5) Narkiewicz K, Montano N, Cogliati C et al. Altered cardiovascular variability in obstructive sleep apnea. Circulation 1998; 98: 1071-7. 9) Ip MS, Tse HF, Lam B et al. Endothelial function in obstructive sleep apnea and response to treatment. Am J Respir Crit Care Med 2004; 169: 348-53. 16) Campos RE, Perez RJ, Grilo RA et al. Long-term Effect of Continuous Positive Airway Pressure on BP in Patients With Hypertension and Sleep Apnea. Chest 2007; 132: 1847-52. 1) Peppard PE, Young T, Palta M et al. Retorospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000; 342: 1378-84. 7) Ip MS, Lam B, Ng MM et al. Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med 2002; 165: 670-6. 11) 石川譲治, 苅尾七臣. 睡眠時無呼吸症候群と高血圧. 血圧 2005; 12: 1168-72. 15) Campos RF, Grilo RA, Perez RJ et al. Effect of continuous positive airway pressure on ambulatory BP in patients with sleep apnea and hypertension: a placebo-controlled trial. Chest 2006; 129: 1459-67. 18) Doherty LS, Kiely JL, Swan V et al. Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome. Chest 2005; 127: 2076-84. 8) Kanagy NL, Walker BR, Nelin LD et al. Role of endothelin in intermittent hypoxia-induced hypertension. Hypertension 2001; 2: 511-5. 17) Modan M, Almog S, Fuchs Z et al. Obesity, glucose intolerance, hyperinsulinemia and response to antihypertensive drugs. Hypertension 1991; 17: 565-73. 6) Moller DS, Lind P, Strung B et al. Abnormal vasoactive hormones and 24-hour blood pressure in obstructive sleep apnea. Am J Hypertens 2003; 16: 274-80. 3) Logan AG, Perlikowski SM, Mente A et al. High prevalence of unrecognized sleepapnea in drugresistant hypertension. J Hypertens 2001; 19: 2271-7. 4) Somers VK, Dyken ME, Claary MP et al. Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest 1995; 96: 1897-904. 2) Nieto FJ, Young TB, Lind BK et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 2000; 283: 1829-36. 13) Akashiba T, Kurashina K, Minemura H et al. Daytime hypertension and the effects of short-term nasal continuous positive airway pressure treatment in obstructive sleep apnea syndrome. Intern Med 1995; 34: 528-32. 14) Becker HF, Jerrentrup A, Ploch T et al. Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation 2003; 107: 68-73. 10) Shamsuzzaman AS, Winnicki M, Wolk R et al. Elevated C-reactive protein in patients with obstructive sleep apnea. Circulation 2002; 105: 2462-4. |
| References_xml | – reference: 9) Ip MS, Tse HF, Lam B et al. Endothelial function in obstructive sleep apnea and response to treatment. Am J Respir Crit Care Med 2004; 169: 348-53. – reference: 4) Somers VK, Dyken ME, Claary MP et al. Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest 1995; 96: 1897-904. – reference: 14) Becker HF, Jerrentrup A, Ploch T et al. Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation 2003; 107: 68-73. – reference: 12) Minemura H, Akashiba T, Yamamoto H et al. Acute effects of nasal continuous positive airway pressure on 24-hour blood pressure and catecholamines in patients with obstructive sleep apnea. Intern Med 1998; 37: 1009-13. – reference: 2) Nieto FJ, Young TB, Lind BK et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 2000; 283: 1829-36. – reference: 13) Akashiba T, Kurashina K, Minemura H et al. Daytime hypertension and the effects of short-term nasal continuous positive airway pressure treatment in obstructive sleep apnea syndrome. Intern Med 1995; 34: 528-32. – reference: 18) Doherty LS, Kiely JL, Swan V et al. Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome. Chest 2005; 127: 2076-84. – reference: 3) Logan AG, Perlikowski SM, Mente A et al. High prevalence of unrecognized sleepapnea in drugresistant hypertension. J Hypertens 2001; 19: 2271-7. – reference: 16) Campos RE, Perez RJ, Grilo RA et al. Long-term Effect of Continuous Positive Airway Pressure on BP in Patients With Hypertension and Sleep Apnea. Chest 2007; 132: 1847-52. – reference: 5) Narkiewicz K, Montano N, Cogliati C et al. Altered cardiovascular variability in obstructive sleep apnea. Circulation 1998; 98: 1071-7. – reference: 1) Peppard PE, Young T, Palta M et al. Retorospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000; 342: 1378-84. – reference: 10) Shamsuzzaman AS, Winnicki M, Wolk R et al. Elevated C-reactive protein in patients with obstructive sleep apnea. Circulation 2002; 105: 2462-4. – reference: 15) Campos RF, Grilo RA, Perez RJ et al. Effect of continuous positive airway pressure on ambulatory BP in patients with sleep apnea and hypertension: a placebo-controlled trial. Chest 2006; 129: 1459-67. – reference: 8) Kanagy NL, Walker BR, Nelin LD et al. Role of endothelin in intermittent hypoxia-induced hypertension. Hypertension 2001; 2: 511-5. – reference: 11) 石川譲治, 苅尾七臣. 睡眠時無呼吸症候群と高血圧. 血圧 2005; 12: 1168-72. – reference: 6) Moller DS, Lind P, Strung B et al. Abnormal vasoactive hormones and 24-hour blood pressure in obstructive sleep apnea. Am J Hypertens 2003; 16: 274-80. – reference: 7) Ip MS, Lam B, Ng MM et al. Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med 2002; 165: 670-6. – reference: 17) Modan M, Almog S, Fuchs Z et al. Obesity, glucose intolerance, hyperinsulinemia and response to antihypertensive drugs. Hypertension 1991; 17: 565-73. |
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| Snippet | Background: The strong association between obstructive sleep apnea syndrome (OSAS) and systemic hypertension is well recognized in some epidemiological... |
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| Title | Relationship between Hypertension and Obstructive Sleep Apnea |
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