Dynamics of Conditions of Arterial Stiffness in Hypertensive Patients with Obstructive Sleep Apnea
There were analyzed arterial stiffness in patients with arterial hypertension (AH) and obstructive sleep apnea (OSA) against of standard antihypertensive treatment during in average 9 months. The aim of the study: to assess conditions of arterial compliance and stiffness in patients with AH and OSA against of standard antihypertensive treatment. Materials and methods. Thirty six hypertensive patients with OSA and nineteen hypertensive patients without OSA (51.55 ± 2.44) were enrolled into the study. The daily sleepiness was assessed by Epworth Sleepiness Scale; there were performed unattended somnograpy by dual-channel portable monitor device, echocardiography, daily blood pressure monitoring, central blood pressure (CBP) estimation and arterial stiffness with applanation tonometry. Results. The results of the study demonstrated that the persons with OSA had significantly higher pulse wave velocity PWVcf (11.26 ± 0.45 m/s vs 9.99 ± 0.42 m/s without OSA, p < 0.05) and central arterial pressure (139.61 ± 4.14 mm Hg vs 125.68 ± 3.83 mm Hg without OSA, р < 0.05). After 9 months of antihypertensive treatment there were 1.72 m/s higher levels of PWVcf in comparison with initial level (12.98 ± 0.55 m/s vs 11.26 m/s, р < 0.02) and 3,27 m/s higher in comparison with the control group (12.98 ± 0.55 m/s versus 9.71 ± 0.56 m/s, р < 0.0001) as well as the PWVcr was significantly 1.26 m/s higher than in the control group (9.51 ± 0.39 m/s vs 8.25 ± 0.35 m/s, p < 0.05). Conclusion. There was concluded about negative impact of OSA on arterial stiffness in patients and standard antihypertensive treatment did not prevent progression of arterial stiffness in patients with AH and OSA without specific treatment of OSA.
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Nastanova ta klinichnyi protokol nadannia medychnoi dopomohy «Arterialna hipertenziia», zatverdzhenyi Nakazom MOZ №384 vid 24.05.2012. К., 2012. 108 s. (in Ukr).
Baguet J.-P., Hammer L., Levy P., Pierre H., Rossini Е ., Mouret S., Ormezzano O., Mallion J.-M., Pepin J.-L. Night-time and diastolic hypertension are common and underestimated conditions in newly diagnosed apnoeic patients. Journal of Hypertension 2005;23:521-527.
Bao G, Metreveli N, Fletcher EC. Acute and chronic blood pressure response to recurrent acoustic arousal in rats. Am J Hypertens 1999;12:504–510.
Ben-Dov IZ, Kark JD, Ben-Ishay D, Mekler J, Ben-Arie L, Bursztyn M. Predictors of all-cause mortality in clinical ambulatory monitoring: unique aspects of blood pressure during sleep. Hypertension. 2007;49:1235–1241.
Blacher J, Asmar R, Djane S, London GM, Safar ME. Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. Hypertension 1999;33:1111–1117.
Brooks D, Horner RL, Kozar LF, Render-Teixeira CL, Phillipson EA. Obstructive sleep apnea as a cause of systemic hypertension. Evidence from a canine model. J Clin Invest 1997;99:106–109.
Chung S, Yoon IY, Lee CH, Kim JW. The association of nocturnal hypoxemia with arterial stiffness and endothelial dysfunction in male patients with obstructive sleep apnea syndrome. Respiration 2010;79:363-9
Dhillon S, Chung SA, Fargher T, Huterer N, Shapiro CM. Sleep apnea, hypertension, and the continuous positive airway pressure (CPAP) Am J Hypertension. 2005;18:594–600
Drager LF, Bortolotto LA, Lorenzi MC, Figueiredo AC, Krieger EM, Lorenzi-Filho G. Early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care 2005;172:613–618.
Epstein LJ; Kristo D; Strollo PJ; Friedman N; Malhotra A; Patil SP; Ramar K; Rogers R; Schwab RJ; Weaver EM; Weinstein MD. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 2009;5:263–276.
Fletcher EC, Lesske J, Qian W, Miller CC III., Unger T Repetitive, episodic hypoxia causes diurnal elevation of blood pressure in rats. Hypertension 1992;19:555–561.
Hla KM, Young TB, Bidwell T, Palta M, Skatrud JB, Dempsey J. Sleep apnea and hypertension. A population based study. Ann Intern Med. 1994;120:382–8.
Ikonomidis I1, Lekakis J, Papadopoulos C, Triantafyllidi H, Paraskevaidis I, Georgoula G, Tzortzis S, Revela I, Kremastinos DT. Incremental value of pulse wave velocity in the determination of coronary microcirculatory dysfunction in never-treated patients with essential hypertension. Am J Hypertens. 2008;21(7):806–813
Kaess BM1, Rong J, Larson MG, Hamburg NM, Vita JA, Levy D, Benjamin EJ, Vasan RS, Mitchell GF. Aortic stiffness, blood pressure progression, and incident hypertension. JAMA. 2012;308:875–881.
Kuller LH1, Shemanski L, Psaty BM, Borhani NO, Gardin J, Haan MN, O'Leary DH, Savage PJ, Tell GS, Tracy R. Subclinical disease as an independent risk factor for cardiovascular disease. Circulation. 1995;92:720–726.
Lanfranchi P., Somers V.K. Obstructive sleep apnea and vascular disease. Respir. Res. 2001;2:315-319
Lang R.M., Bierig M., Devereux R.B. Flachskampf FA, Foster E, Pellikka PA, Picard MH,. Roman MJ, Seward J, Shanewise J, Solomon S, Spencer KT, Sutton M St. J, Stewart W. Recommendations for chamber quantification // Eur. J. of Echocardiogr.2006;7:79-108.
Lavie P, Ben-Yosef R, Rubin AE. Prevalence of sleep apnea syndrome among patients with essential hypertension. Am Heart J. 1984;108: 373–376.
Lavie P., Herer P., Hoffstein V. Obstructive sleep apnea syndrome as a risk factor for hypertension: population study. BMJ. 2000;320:479-482.
Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, Ducimetiere P, Benetos A. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001;37:1236-41
Lesske J, Fletcher EC, Bao G, Unger T. Hypertension caused by chronic intermittent hypoxia–influence of chemoreceptors and sympathetic nervous system. J Hypertens 1997;15: 1593–1603,
Levy P, Pepin JL, Arnaud C, Baguet JP, Dematteis M, Mach F. Obstructive sleep apnea and atherosclerosis. Prog Cardiovasc Dis 2009;51:400-10.
Litvin AY, Sukmarova ZN, Elfimova EM, Aksenova AV, Galitsin PV, Rogoza AN, Chazova IE Effects of CPAP on “vascular” risk factors in patients with obstructive sleep apnea and arterial hypertension Vasc Health Risk Manag. 2013; 9: 229–235.
Mancia G, Fagard R, Narkiewicz K, Redo´n J, Zanchetti A, Bohm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Rick E, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE , Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F. 2013 ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) Journal of Hypertension 2013, 31:1281–1357
Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005; 365: 1046–1053,
Masugata H, Senda S, Inukai M, Himoto T, Hosomi N, Murao K, Okada H, Goda F. Association between left ventricular hypertrophy and changes in arterial stiffness during hypertensive treatment. Clin Exp Hypertens. 2014; 36:258-62.
Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, Hamburg NM, Vita JA, Levy D, Benjamin EJ. Arterial stiffness and cardiovascular events: the Framingham heart study.Circulation 2010 Feb 2;121(4):505-11
Mitchell GF, van Buchem MA, Sigurdsson S, Gotal JD, Jonsdottir MK, Kjartansson Ó, Garcia M, Aspelund T,Harris TB, Gudnason V, Launer LJ. Arterial stiffness,pressure and flow pulsatility and brain structure and function: the Age, Gene/Environment Susceptibility – Reykjavik study. Brain. 2011;134(Pt 11):3398–3407
Mule G, Cottone S, Vadala A, Volpe V, Mezzatesta G, Mongiovì R, Piazza G, Nardi E, Andronico G,Cerasola G. Relationship between albumin excretion rate and aortic stiffness in untreated essential hypertensive patients. J Intern Med. 2004;256(1):22–29.
O’Brien E, Parati G, Stergiou G, Asmar R, Beilin L, Bilo G, Clement D, de la Sierra A, de Leeuw P, Dolan E,Fagard R, Graves J, Head GA, Imai Y, Kario K, Lurbe E, Mallion JM, Mancia G, Mengden T, Myers M,Ogedegbe G, Ohkubo T, Omboni S, Palatini P, Redon J, Ruilope LM, Shennan A, Staessen JA,vanMontfrans G, Verdecchia P, Waeber B, Wang J, Zanchetti A, Zhang Y; European Society of Hypertension Working Group on Blood Pressure Monitoring.. European Society of Hypertension position paper on ambulatory blood pressure monitoring. J Hypertens. 2013;31:1731–1767.
Pecker Y, Hedner J, Norum J, Kraiczi H, Carlson J. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7 year follow-up. Am J Respir Crit Care Med. 2002;166:159–165
Peppard P.E., Young T., Palta M., Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N. Engl. J. Med. 2000;342:1378-1384.
Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, Mullins R, Jenkinson C, Stradling JR, Davies RJ. Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet 2002;359:204–210
Phillips C, Hedner J, Berend N, Grunstein R. Diurnal and obstructive sleep apnea influences on arterial stiffness and central blood pressure in men. Sleep 2005;28: 604–609.
Portaluppi F, Provini F, Cortelli P, Plazzi G, Bertozzi N, Manfredini R, Fersini C, Lugaresi E. Undiagnosed sleep-disordered among male nondippers with essential hypertension. J Hypertens. 1997;15:227–1233
Psaty BM, Furberg CD, Kuller LH, Bild DE, Rautaharju PM, Polak JF, Bovill E, Gottdiener JS. Traditional risk factors and subclinical disease measures as predictors of first myocardial infarction in older adults: the Cardiovascular Health Study. Arch Intern Med. 1999;159(12):1339–1347.
Schulz R, Seeger W, Fegbeutel C, Husken H, Bodeker RH, Tillmanns H, Grebe M. Changes in extracranial arteries in obstructive sleep apnea. Eur Respir J 2005; 25: 69–74.
Silverberg DS, Oksenberg A, Iaina A. Sleep-related breathing disorders as a major cause of essential hypertension: fact or fiction? Curr Opin Nephrol Hypertens. 1998;7:353–357.
Silvestrini M, Rizzato B, Placidi F, Baruffaldi R, Bianconni A, Diomedi M. Carotid artery wall thickness in patients with obstructive sleep apnea syndrome. Stroke 2002;33:1782–1785.
Somers VK, Dyken ME, Clary MP, Abboud FM. Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest. 1995;96:1897–1904
Somers VK, White DP, Amin R, Abraham WT, Costa F, Culebras A, Daniels S, Floras JS, Hunt CE, Olson LJ, Pickering TG, Russell R, Woo M, Young t. Sleep apnea and cardiovascular disease: an American Heart Association/american College Of Cardiology Foundation Scientific Statement from American heart Association Council for High Blood Pressure Research Professional Educational Committee, Council on Clinical Cardiology, Stroke Council, and Council On Cardiovascular Nursing. In collaboration with with the National Heart, Lung and Blood Institute National Center on Sleep Disorders Research (National Institute of Heart ). Circulation 2008; 118: 1080-1111;
Van Bortel LM, Laurent S, Boutouyrie P, Chowienczyk P, Cruickshank JK, De Backer T, Filipovsky J,Huybrechts S, Mattace-Raso FU, Protogerou AD, Schillaci G, Segers P, Vermeersch S, Weber T; Artery Society; European Society of Hypertension Working Group on Vascular Structure and Function; European Network for Noninvasive Investigation of Large Arteries. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens 2012; 30:445–448.
Wada T, Kodaira K, Fujishiro K, Maie K, Tsukiyama E, Fukumoto T, Uchida T, Yamazaki S. Correlation of ultrasound-measured common carotid artery stiffness with pathological findings. Arterioscler Thromb. 1994 Mar;14(3):479-82.
Waller P.C., Bhopal R.S. Is snoring a cause of vascular disease. Lancet. 1989;1:143-146
Weber T, Auer J, O'Rourke MF, Kvas E, Lassing E, Berent R, Eber B. Arterial stiffness, wave reflections and the risk for coronary artery disease. Circulation 2004;109:184–189.
Wolk R, Shamsuzzaman AS, Somers VK. Obesity, sleep apnea, and hypertension. Hypertension. 2003;42:1067–1074.
Vardan S, Dunsky MH, Hill NE, Mookherjee S, Smulyan H, Warner RA. Systemic systolic hypertension in the elderly: correlation of hemodynamics, plasma volume, renin, aldosterone, urinary metanephrines and response to thiazide therapy. Am J Cardiol. 1986;58:1030 –1034.
Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 2010 Mar 30;55(13):1318-27.
Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002;165:1217–1239.
Young T., Peppard P., Palta M., Hla M., Finn L., Morgan B., Skatrud J. Population-based study of sleep-disordered breathing as a risk factor for hypertension. Archives of Internal Medicine. 1997;157:1746-52.
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