Source: Annual Congress 2001 - Cardiovascular pathophysiology in OSA
Disease area: Sleep and breathing disorders

Abstract

Background: We have recently demonstrated that 61% of patients have upper airway obstruction (UAO)(RDI>10) in the first twenty four hours of stroke and that increasing RDI is an independent risk factor for mortality at 6 months. The aim of this study is to assess the degree of blood pressure variability associated with UAO after stroke. Methods: 12 patients with acute stroke, 14 patients under investigation for obstructive sleep apnoea (OSA) and 12 normal controls were studied. Each patient underwent a limited sleep study (Alice 4) while continuous mean blood pressure was monitored non-invasively with a Portapres. A moving 10 second average blood pressure was calculated and each 10mmHg dip in blood pressure below this value was then recorded. Results: Stroke patients and controls were similar in terms of age (77.9 vs 71.4 years, p>0.05)and BMI (24.9 vs 25.7 kg/m2, p>0.05). Stroke patients were similar to the OSA patients in terms of mean RDI (16.4 vs 21.3 events per hour, p>0.05) and percentage of night spent snoring (13 vs 22.8%, p>0.05). However OSA patients were younger (47.7 years, p<0.0001) and more obese (BMI 31.1kg/m2, p<0.006). The stroke patients had significantly more 10 mmHg dips in blood pressure than the controls (104 vs 26 dips/hr,p<0.02)and than those patients with OSA (104 vs 43 dips/hr, p<0.04). Furthermore the OSA patients demonstrated more blood pressure variability than the controls (43 vs 26 dips/hr, p<0.05), although they were younger and more obese. Conclusion: Blood pressure variability is common after stroke, and may be in part due to repeated obstruction of the upper airway. This may explain the relationship between UAO and increasing mortality after stroke

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Citations should be made in the following way:
P. M. Turkington, P. Wanklyn, J. Bamford, M. W. Elliott (Leeds, United Kingdom). The effect of upper airway obstruction in acute stroke on blood pressure variability. Eur Respir J 2001; 16: Suppl. 31, 3500

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