Relationship of systolic BP to obstructive sleep apnea in patients with heart failure.
OBJECTIVE
Obstructive sleep apnea (OSA) is an independent risk factor for hypertension in the general population. Hypertension is, in turn, an important risk factor for the development and progression of congestive heart failure (CHF). Our objective was to determine whether OSA would be associated with elevated daytime BP in medically treated patients with CHF.


METHODS
Cross-sectional study.


METHODS
Tertiary care, university-affiliated sleep disorders and heart failure clinics.


METHODS
Three hundred one consecutive patients with CHF.


RESULTS
We measured daytime BP and performed overnight sleep studies to assess for the presence of OSA. Among these patients, OSA was present in 121 patients (40%) and their systolic BP was significantly higher than in patients without OSA. Patients with OSA were 2.89 times (95% confidence interval, 1.25 to 6.73) more likely to have systolic hypertension (ie, BP > or = 140 mm Hg) than those without OSA after controlling for other risk factors, including obesity. The degree of systolic BP elevation was directly related to the frequency of obstructive apneas and hypopneas.


CONCLUSIONS
In medically treated patients with CHF, daytime systolic BP and the prevalence of systolic hypertension are significantly increased in patients with OSA, compared to those without OSA, independent of other potentially confounding factors. OSA may therefore have contributed to the presence of systolic hypertension in some of these patients.
Sleep Research Laboratory, Toronto Rehabilitation Institute, ON, Canada.
Don D
DD
Sin
Fabia
F
Fitzgerald
John D
JD
Parker
Gary E
GE
Newton
Alexander G
AG
Logan
John S
JS
Floras
T Douglas
TD
Bradley
D000368:Aged; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000503:physiopathology*; D013318:Stroke Volume