title: Low physical activity is a determinant for elevated blood pressure in high cardiovascular risk obstructive sleep apnea.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) is associated with cardiovascular morbidity, including hypertension. Beyond the severity of nocturnal hypoxia, other factors such as metabolic abnormalities but also sedentary behaviors and insufficient physical activity may contribute to elevated blood pressure (BP). To clarify the respective role of these factors as determinants of BP in OSA patients, we examined the relationship between BP and anthropometrics, severity of sleep apnea, and objectively measured physical activity and sedentary behaviors.
  
  
  METHODS
  Ninety-five adults presenting with OSA (apnea-hypopnea index > 10 events/h) and high cardiovascular risk (63.3 ± 8.8 y; body mass index: 29.9 ± 4.9 kg/m(2); apnea-hypopnea index: 41.3 ± 17.5/h; cardiovascular risk score: 13.5 ± 3.7%) were included. Physical activity and sedentary behaviors were objectively assessed by actigraphy, and self-measured home BP monitoring was measured. Logistic regression models adjusted for sex, age, and body mass index were built to identify the predictors of self-measured morning and evening BP.
  
  
  RESULTS
  Physical activity was significantly related to obesity but not to the severity of sleep apnea or sleepiness. Sedentary behaviors were associated with self-measured morning and evening systolic BP (r = 0.32, P = .002; r = 0.29, P = .004). Steps per day were inversely associated with evening BP (r = -0.27, P = .01). Univariate analysis identified steps/d and time spent in vigorous physical activity as determinants for evening self-measured BP. In multivariate analysis, only steps/d were identified as a significant determinant of evening BP.
  
  
  CONCLUSIONS
  Physical activity is the major determinant for evening BP in adults with OSA presenting high cardiovascular risk. Our results emphasize the need for lifestyle counseling programs in combination with CPAP to encourage regular physical activity in OSA subjects to obtain better BP control. (ClinicalTrials.gov registration NCT01226641.)
authors.forename: Monique
authors.initials: M
authors.lastname: Mendelson
authors.forename: Renaud
authors.initials: R
authors.lastname: Tamisier
authors.forename: David
authors.initials: D
authors.lastname: Laplaud
authors.forename: Sonia
authors.initials: S
authors.lastname: Dias-Domingos
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Baguet
authors.forename: Laurent
authors.initials: L
authors.lastname: Moreau
authors.forename: Christian
authors.initials: C
authors.lastname: Koltes
authors.forename: Léonidas
authors.initials: L
authors.lastname: Chavez
authors.forename: Gilles
authors.initials: G
authors.lastname: de Lamberterie
authors.forename: Frédéric
authors.initials: F
authors.lastname: Herengt
authors.forename: Patrick
authors.initials: P
authors.lastname: Levy
authors.forename: Patrice
authors.initials: P
authors.lastname: Flore
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Pépin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D011446:Prospective Studies; D012307:Risk Factors; D057185:Sedentary Behavior; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology* / Q000523:psychology