title: Relationship between obstructive sleep apnea and markers of cardiovascular alterations in never-treated hypertensive patients.
abstract: We addressed a question if there is a relationship between severity of newly diagnosed obstructive sleep apnea (OSA) and markers of cardiovascular alterations in middle-aged untreated hypertensive patients. In 121 consecutive patients with never-treated essential hypertension (mean age 35.9±10.1 years; 97 men and 24 women) evaluation of office and ambulatory blood pressure (BP) measurements, metabolic syndrome (MS) components and markers of alterations in cardiovascular system including left ventricular structure and function, carotid artery wall intima-media thickness (cIMT) and urinary albumin excretion (UAE) was performed. OSA was classified as mild (apnea/hypopnea index (AHI) 5-15 events h(-1)) or moderate-to-severe (AHI >15 events h(-1)). Mild and moderate-to-severe OSA were diagnosed in 30% and 20% of patients, respectively. No differences in nighttime BP levels and decline between patients with and without OSA were observed. The patients with moderate-to-severe OSA were characterized by higher cIMT (0.74±0.16 vs. 0.60±0.15 mm; P=0.001), UAE (14.5±6.9 vs. 10.0±8.0 mg 24 h(-1); P=0.014), relative wall thickness (0.42±0.05 vs. 0.39±0.05; P=0.023) and by a higher degree of diastolic dysfunction (E'-wave velocity 11.4±3.2 vs. 15.5±3.8 m s(-1); P<0.001) as compared with the patients without OSA. In multivariate analysis, AHI independently of BP and MS components correlated with UAE, relative wall thickness and E'-wave velocity. In the middle-aged never-treated hypertensive patients, moderate-to-severe OSA correlates with markers of cardiovascular alterations independently of BP levels and MS components.
authors.affiliation: Department of Hypertension, Institute of Cardiology, Warsaw, Poland.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Prejbisz
authors.affiliation: Department of Hypertension, Institute of Cardiology, Warsaw, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Florczak
authors.affiliation: Department of Hypertension, Institute of Cardiology, Warsaw, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Pręgowska-Chwała
authors.affiliation: Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Klisiewicz
authors.affiliation: Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Kuśmierczyk-Droszcz
authors.affiliation: Department of Heart Failure and Transplantation, Institute of Cardiology, Warsaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Zieliński
authors.affiliation: Department of Hypertension, Institute of Cardiology, Warsaw, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Makowiecka-Cieśla
authors.affiliation: Department of Hypertension, Institute of Cardiology, Warsaw, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Kołodziejczyk-Kruk
authors.affiliation: IV Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Śliwiński
authors.affiliation: Department of Hypertension, Institute of Cardiology, Warsaw, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Januszewicz
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000453:epidemiology / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D002319:Cardiovascular System / Q000473:pathology* / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D000075222:Essential Hypertension; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D015999:Multivariate Analysis; D009819:Office Visits; D017286:Polysomnography; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology* / Q000503:physiopathology*