Abnormally increased endothelin-1 in plasma during the night in obstructive sleep apnea: relation to blood pressure and severity of disease.
BACKGROUND
The mechanisms involved in development and maintenance of hypertension in obstructive sleep apnea (OSA) are not clarified. We hypothesize that patients with OSA have an abnormal nocturnal level of some vasoactive hormones during the night.


METHODS
We studied 32 patients with OSA and 19 healthy control subjects during The night-time with serial determinations of endothelin-1 (ENDO-1), angiotensin II (Ang II), renin (PRC), aldosterone (ALDO) in plasma, and blood pressure (BP), and oxygen saturation.


RESULTS
Patients with OSA had a higher plasma level of ENDO than healthy controls and the mean nocturnal level of ENDO correlated significantly to the apnea-hypopnea index (AHI) as a measure of the severity of OSA. This correlation remained statistically significant after analysis in a general linear model with correction for confounders. Patients with OSA also had a significantly higher BP than healthy controls and the ambulatory BP correlated positively to the AHI in patients with OSA. No significant differences were measured in Ang II, PRC, and ALDO between the two groups. The correlation between AHI and ENDO supports OSA as a stimulus of endothelin release or increased endothelin levels contributing to the severity of OSA.


CONCLUSIONS
Endothelin seems to be a pathogenic factor in generating hypertension in OSA.
Gjørup
Pia Holland
PH
Departments of Medical Research and Medicine, Holstebro Hospital and Aarhus University, DK-7500 Holstebro, Denmark. pihan@ringamt.dk
Sadauskiene
Laima
L
Wessels
Jost
J
Nyvad
Ole
O
Strunge
B
B
Pedersen
Erling Bjerregaard
EB
D000328:Adult; D000450:Aldosterone / Q000097:blood; D000804:Angiotensin II / Q000097:blood; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D012083:Renin / Q000097:blood; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000150:complications
D000959:Antihypertensive Agents; D019332:Endothelin-1; D000804:Angiotensin II; D000450:Aldosterone; D012083:Renin; D010100:Oxygen