Περίληψη:
Blood pressure (BP) behavior during exercise is not clear in
hypertensive patients with obstructive sleep apnea (OSA). The authors
studied 57 men with newly diagnosed essential hypertension and untreated
OSA (apnea-hypopnea index [AHI] >= 5) but without daytime sleepiness
(Epworth Sleepiness Scale score <= 10), and an equal number of
hypertensive controls without OSA matched for age, body mass index, and
office systolic BP. All patients underwent ambulatory BP measurements,
transthoracic echocardiography, and exercise treadmill testing according
to the Bruce protocol. A hypertensive response to exercise (HRE) was
defined as peak systolic BP >= 210 mm Hg. Patients with OSA and control
patients had similar ambulatory and resting BP, ejection fraction, and
left ventricular mass. Peak systolic BP was significantly higher in
patients with OSA (197.6 +/- 25.6 mm Hg vs 187.8 +/- 23.6 mm Hg; P=.03),
while peak diastolic BP and heart rate did not differ between groups.
Furthermore, an HRE was more prevalent in patients with OSA (44% vs
19%; P=.009). Multiple logistic regression revealed that an HRE is
independently predicted by both the logAHI and minimum oxygen saturation
during sleep (odds ratio, 3.94; confidence interval, 1.69-9.18; P=.001
and odds ratio, 0.94; confidence interval, 0.89-0.99; P=.02,
respectively). Exaggerated BP response is more prevalent in nonsleepy
hypertensives with OSA compared with their nonapneic counterparts. This
finding may have distinct diagnostic and prognostic implications. (C)
2013 Wiley Periodicals, Inc.
Συγγραφείς:
Kasiakogias, Alexandros
Tsioufis, Costas
Thomopoulos, Costas and
Andrikou, Ioannis
Kefala, Anna
Papadopoulos, Dimitrios
Dima,
Ioanna
Milkas, Anastasios
Kokkinos, Peter
Stefanadis,
Christodoulos
