title: Lateral pharyngoplasty reduces nocturnal blood pressure in patients with obstructive sleep apnea.
abstract: OBJECTIVE
  To compare the values of 24-hour ambulatory blood pressure monitoring (ABPM) in patients with obstructive sleep apnea (OSA), before and after lateral pharyngoplasty, and to investigate the influence of pre- and post-treatment polysomnographic and anthropometric variations on changes in ABPM.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Arterial blood pressure with 24-hour ABPM and nocturnal polysomnography were measured before and 6 months after surgery in 18 consecutively evaluated adults with OSA at a tertiary center.
  
  
  RESULTS
  A total of 83.3% were normotensive patients. Nocturnal measurements showed a decrease of 5.3 mmHg in mean arterial pressure (MAP; P = .01), 7.4 mmHg in mean arterial systolic pressure (SP; P = .006), and 4.2 mmHg in mean arterial diastolic pressure (DP; P = .03), leading to significant reductions in all 24-hour measurements: 3.6 mmHg in MAP, 4.8 mmHg in SP, and 2.9 mmHg in DP. There were also significant mean reductions in the apnea-hypopnea index (AHI), from 33.5 to 20.9 (P = .02), arousal index, from 31.6 to 16.7 (P = .005), and percentage of total sleep time with oxyhemoglobin saturation < 90%, from 10.6% to 0.9% (P = .008). No correlations were noted between the measurements of arterial blood pressure and polysomnographic or anthropometric variations.
  
  
  CONCLUSIONS
  In this small case series, lateral pharyngoplasty reduced the values obtained in the 24-hour ABPM due to a significant reduction of blood pressures during sleep in patients with OSA 6 months after surgery. Although the patients presented with reductions in AHI, arousals, and desaturation time, this was not correlated with the improvement in arterial blood pressure.
authors.affiliation: Department of Otolaryngology, State Public Service Hospital of São Paulo, São Paulo, Brazil.
authors.forename: Carolina F
authors.initials: CF
authors.lastname: de Paula Soares
authors.forename: Luciano
authors.initials: L
authors.lastname: Cavichio
authors.forename: Michel B
authors.initials: MB
authors.lastname: Cahali
mesh_terms: D000328:Adult; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D010614:Pharynx / Q000601:surgery*; D017286:Polysomnography; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology* / Q000601:surgery*; D055815:Young Adult
keywords: Obstructive sleep apnea; blood pressure; lateral pharyngoplasty; otorhinolaryngological surgical procedures; therapy