24-hour blood pressure profile and systemic inflammation in patients with stable coronary artery disease with obstructive sleep apnea

Abstract

Aim. To evaluate 24-hour blood pressure (BP) profile and systemic inflammation in patients with coronary artery disease (CAD) depending on the presence of obstructive sleep apnea (OSA).Material and methods. This cross-sectional cohort study included 132 patients with CAD aged 62,3±6,9 years. Depending on OSA, all patients were divided into 2 groups: group 1 (n=60) — without OSA, group 2 (n=72) — with OSA. Systemic inflammation was assessed using neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), Systemic immune-inflammation index (SII) — platelets´neutrophils/lymphocytes. Blood pressure was monitored with assessment of average daily values, circadian rhythm, and variability.Results. Patients with OSA had higher nighttime blood pressure values (p<0,05) and 24-hour variability (p<0,05). In group 2 patients, a pathological blood pressure profile was detected in 66,7% of cases, while in group 1 — in 36,7%. The systemic inflammation indices were significantly higher in patients with OSA than in the group without OSA — NLR by 18,8% (p<0,01), PLR by 22,5% (p<0,01), MLR by 19,0% (p<0,01), SII by 41,0% (p<0,001).Conclusion. We established that patients with coronary artery disease and OSA have more pronounced systemic inflammation, more often have a pathological 24-hour BP profile ("non-dipper", "night-peaker"), BP variability, higher values of average 24-hour, daytime and nighttime BP compared with patients without OSA.

Keywords

• hypertension
• coronary artery disease
• obstructive sleep apnea
• systemic inflammation