Source: Annual Congress 2011 - Obstructive sleep apnoea in children and adults
Disease area: Sleep and breathing disorders

Abstract

Obstructive sleep apnea (OSA) is an important risk factor for systemic arterial hypertension (SH).
Aim: Identify the best predictors for SH in patients with OSA.
Methods: We prospectively followed 589 consecutive patients (pts) with clinically suspected OSA. The pts were included and followed-up for a mean period of 7 years by sleep questionnaires, anthropometric measurements, polisomnography for apnea-hypopnea index (AHI) (values: normal 0-4, mild 5-14, moderate 15-29, severe over 30) and history of SH. We evaluated the Odds Ratio (OR) and 95% confidence interval (CI) in a univariate analysis and the independent variables.
Results: 436 males (71%) 153 females (29%), age 50±12 years (range 18-84 years) were included. The Body Mass Index (BMI) was 34±6 kg/m2 (range17-56 kg/m2) and the mean AHI 36/h±28. SH was found in 59% patients. The time from diagnostic to abnormal changes in blood pressure values was 7±5years. The structure of the study population according to European Society of Hypertension 2007 Guidelines: from the 59% of pts with SH: 11% with high normal values, 15% stage I, 29% stage II, 8% stage III. AHI in all 3 levels, with reference normal, is extremely significant (p<0.001) in hypertensive patients. Only severe OSA is the strongest predictor for hypertension, OR 3,2 (p<0.001, CI 1, 67–5, 59). Mild and moderate OSA did not significantly influence the appearance of SH (p<0,14, OR 0,58, CI 0,29-1,20, p<0,24, OR 1,52, CI 0,76-2,86). SH is a weak predictor for OSA in univariate analysis, p = 0,045, OR 1,76, CI 1,01-3,08.
Conclusion: Patients with OSA are exposed to a higher risk of developing SH. A strong predictor for SH is only severe OSA.

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Citations should be made in the following way:
S. M. Frent, D. Lighezan, V. Tudorache, C. Ardelean, D. Dimitriu, S. Mihaicuta (Timisoara, Romania). Longterm follow-up of severe obstructive sleep apnea-hypopnea syndrome and prediction of systemic arterial hypertension. Eur Respir J 2011; 38: Suppl. 55, 3243

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