title: Obstructive sleep apnea and plasma natriuretic peptide levels in a community-based sample.
abstract: OBJECTIVE
  We hypothesized that alterations in cardiac hemodynamics associated with obstructive sleep apnea-hypopnea (OSAH) would be reflected in higher natriuretic peptide levels. We examined the association of OSAH with natriuretic peptides in a community-based sample.
  
  
  METHODS
  Cross-sectional, retrospective, observational study.
  
  
  METHODS
  Framingham Heart Study Offspring Cohort and Sleep Heart Health Study.
  
  
  METHODS
  Community-based sample of 623 individuals.
  
  
  METHODS
  Full-montage home polysomnography was used to determine apnea-hypopnea index (AHI) and percentage of time with an oxyhemoglobin saturation < 90% (PctLt90). Sensitive immunoradiometric assays were used to measure plasma B-type (BNP) and N-terminal pro-atrial natriuretic peptide (NT-ANP). Multivariable regression was used to examine the relations between natriuretic peptides and indicators of OSAH, adjusting for age, sex, body mass index, and clinical covariates.
  
  
  RESULTS
  No statistically significant relations between OSAH indices and BNP were observed in the multivariable model. Compared with an AHI < 5, relative levels of 1.20, 0.88, and 0.91 were observed forAHI categories 5-15, 15-30, >30 events per hour, respectively. For NT-ANP, no significant relations were seen with AHI in the multivariable model (relative levels of 0.98, 0.91, and 0.90). An inverse association was observed between NT-ANP and PctLt90 in age- and sex-adjusted models (relative levels of 0.93, 0.87, and 0.80), although this association became statistically nonsignificant after adjusting for body mass index.
  
  
  CONCLUSIONS
  Lack of association of natriuretic peptides with OSAH indices suggests that undiagnosed OSAH may not be associated with major alterations in left ventricular function, as reflected in morning natriuretic peptide levels.
authors.affiliation: Boston University School of Medicine, Boston, MA, USA.
authors.forename: Anjali A
authors.initials: AA
authors.lastname: Patwardhan
authors.forename: Martin G
authors.initials: MG
authors.lastname: Larson
authors.forename: Daniel
authors.initials: D
authors.lastname: Levy
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.forename: Eric P
authors.initials: EP
authors.lastname: Leip
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Keyes
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wang
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Gottlieb
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
mesh_terms: D001281:Atrial Fibrillation / Q000453:epidemiology; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D045265:Natriuretic Peptides / Q000097:blood*; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D017286:Polysomnography; D015995:Prevalence; D012111:Residence Characteristics; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology
chemical_list: D045265:Natriuretic Peptides