Türk Uyku Tıbbı Dergisi (Dec 2020)
Predictors of Nocturnal Hypertension in Sleep-related Breathing Disorders: Are We Aware of the Patients with Occult Hypertension During Sleep?
Abstract
Objective:Increased risk of hypertension and vascular diseases are the major consequences of obstructive sleep apnea (OSA). We aimed to investigate risk factors influencing the nocturnal blood pressure (BP) levels in OSA patients.Materials and Methods:This study was designed as cross-sectional. Polysomnographic evaluation results and ambulatory BP measurements were recorded. Participants without history of arterial hypertension and anti-hypertensive treatment were included.Results:The study group consisted of total 294 participants with OSA (62.9%) and non-OSA (37.1%). There was a statistically significant relationship between nocturnal hypertension and isolated morning diastolic hypertension and OSA severity when compared with non-OSA group. Univariate analysis results revealed that Body Mass index (BMI), neck circumference, Oxygen Desaturation index (ODI) and Apneahypopnea index (AHI) were the four major independent factors about predicting patients with nocturnal hypertension. In multivariate analysis only BMI and ODI were found as independent factors those differentiate hypertensive ones from normotensive individuals. No correlation was found between nocturnal hypertension and age, arousal index, gender, and smoking status (p>0.05). The cut-off value for predicting nocturnal hypertension according to ODI values was found to be 34.45.Conclusion:Both BMI and ODI were found as independent and statistically significant factors which differentiated hypertensive and normotensive individuals. Even though, monitoring BP during polysomnography is not a routine practice, we recommend that when the presence of suspicion regarding occult hypertension, further PSG evaluation with nocturnal BP monitoring can be performed as a screening method especially in the higher risk group of patients those have independent risk factors.
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