What question did this study set out to answer?

To assess whether newly diagnosed, untreated essential hypertensive patients with obstructive sleep apnea syndrome exhibit increased arterial stiffness compared to matched hypertensive controls.

November 30, 2006Journal of Hypertension

The incremental effect of obstructive sleep apnoea syndrome on arterial stiffness in newly diagnosed essential hypertensive subjects

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Why the study?

Does the presence of obstructive sleep apnoea syndrome increase arterial stiffness in newly diagnosed essential hypertensive subjects?

Key Points

To assess whether newly diagnosed, untreated essential hypertensive patients with obstructive sleep apnea syndrome exhibit increased arterial stiffness compared to matched hypertensive controls.
Enrolled 46 consecutive untreated stage I–II essential hypertensive patients with obstructive sleep apnea syndrome (35 men, aged 49 ± 8 years) and 53 hypertensive controls without apnea matched for age, sex, and smoking status.
Assessed all participants using polysomnography, echocardiography, and carotid–femoral pulse wave velocity (c–fPWV) to quantify aortic stiffness.
Hypertensive subjects with sleep apnea had a 9% higher carotid–femoral pulse wave velocity compared to those without apnea (8.56 ± 0.49 vs 7.85 ± 0.93 m/s, P = 0.001), remaining significant after adjustment for confounders (P = 0.04).
Patients with sleep apnea had significantly higher body mass index (31.4 ± 4 vs 29.3 ± 4 kg/m2, P = 0.015), office systolic/diastolic blood pressure (151/99 vs 145/94 mmHg, P < 0.05), and relative wall thickness (0.46 ± 0.06 vs 0.42 ± 0.07, P = 0.010).
Carotid–femoral pulse wave velocity correlated positively with logAHI (r = 0.389, P = 0.0001) and negatively with minimum oxygen saturation (r = −0.418, P = 0.0001).

Structured PICO

Does the presence of obstructive sleep apnoea syndrome increase arterial stiffness in newly diagnosed essential hypertensive subjects?

Population

99 patients with newly diagnosed untreated stage I-II essential hypertension, including 46 with obstructive sleep apnoea syndrome (OSAS) (35 men, aged 49 ± 8 years) and 53 without OSAS, matched for age, sex, and smoking status.

Intervention

Presence of obstructive sleep apnoea syndrome (OSAS) defined as apnoea/hypopnoea index (AHI) ≥ 5

Comparator

Absence of OSAS (AHI < 5) in matched hypertensive individuals

Outcome

Aortic stiffness evaluated by carotid-femoral pulse wave velocity (c-fPWV)surrogate

The presence of obstructive sleep apnea syndrome in newly diagnosed hypertensive patients is associated with significantly increased arterial stiffness, suggesting accelerated vascular damage.

Discussion

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Implication

Supports link between OSAS and arterial stiffness in hypertension; hypothesis-generating and should not yet change practice.

Cite This Study

Tsioufis et al. (2006) studied this question.

synapsesocial.com/papers/69d56dce75589c71d767d0c4 https://doi.org/10.1097/hjh.0b013e32801092c1

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