title: OSA is common and independently associated with hypertension and increased arterial stiffness in consecutive perimenopausal women.
abstract: BACKGROUND
  Perimenopause is associated with increased cardiovascular risk. OSA is an emerging risk factor for cardiovascular disease, particularly among men, but the independent contribution of OSA to cardiovascular risk in climacteric women is not clear.
  
  
  METHODS
  We evaluated 277 consecutive women (age, 56 [52-61] years; BMI, 28 [25-32] kg/m2) without manifest cardiovascular disease (heart failure, coronary disease, or stroke). All women underwent 24-h ambulatory BP monitoring, arterial stiffness evaluation (pulse wave velocity), and portable sleep study.
  
  
  RESULTS
  OSA (apnea-hypopnea index ≥ 5 events/h) and moderate to severe OSA (apnea-hypopnea index ≥ 15 events/h) were diagnosed in 111 (40.1%) and 31 (11.1%) women, respectively. None of the participants had received a previous diagnosis of OSA. Women with moderate to severe OSA vs those without OSA had a higher prevalence of hypertension, were prescribed more medications for hypertension, had higher awake BP (systolic, 133 [125-142] vs 126 [119-134] mm Hg [P < .01]; diastolic, 82 [78-88] vs 79 [74-85] mm Hg [P = .07]), higher nocturnal BP (systolic, 125 [118-135] vs 115 [109-124] mm Hg [P < .01]; diastolic, 73 [69-79] vs 69 [62-75] mm Hg [P < .01]), and more arterial stiffness (pulse wave velocity, 11.5 [10.1-12.3] m/s vs 9.5 [8.6-10.8] m/s, P < .001). Oxygen desaturation index during the night was independently associated with 24-h arterial BP and arterial stiffness (per five-unit increase in oxygen desaturation index, β = 1.30 [95% CI, 0.02-2.54; P = .04] vs 0.22 [95% CI, 0.03-0.40; P = .02] in women with vs without OSA, respectively).
  
  
  CONCLUSIONS
  OSA is common, underdiagnosed, and independently associated with high BP and increased arterial stiffness in perimenopausal women.
authors.affiliation: Sleep and Heart Laboratory, Pernambuco, Brazil. Electronic address: rppedrosa@terra.com.br.
authors.forename: Rodrigo P
authors.initials: RP
authors.lastname: Pedrosa
authors.affiliation: Sleep and Heart Laboratory, Pernambuco, Brazil; Pronto Socorro Cardiológico de Pernambuco (PROCAPE) da Universidade de Pernambuco, and PROCAPE da Universidade de Pernambuco, Pernambuco, Brazil.
authors.forename: Isly M L
authors.initials: IML
authors.lastname: Barros
authors.affiliation: Sleep Laboratory, Pulmonary Division, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Luciano F
authors.initials: LF
authors.lastname: Drager
authors.affiliation: University Hospital, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcio S
authors.initials: MS
authors.lastname: Bittencourt
authors.affiliation: Sleep and Heart Laboratory, Pernambuco, Brazil.
authors.forename: Ana Kelley L
authors.initials: AKL
authors.lastname: Medeiros
authors.affiliation: Sleep and Heart Laboratory, Pernambuco, Brazil.
authors.forename: Liana L
authors.initials: LL
authors.lastname: Carvalho
authors.affiliation: Sleep and Heart Laboratory, Pernambuco, Brazil.
authors.forename: Thais C
authors.initials: TC
authors.lastname: Lustosa
authors.affiliation: Sleep and Heart Laboratory, Pernambuco, Brazil.
authors.forename: Martinha M B
authors.initials: MMB
authors.lastname: Carvalho
authors.affiliation: Sleep and Heart Laboratory, Pernambuco, Brazil.
authors.forename: Moacir N L
authors.initials: MNL
authors.lastname: Ferreira
authors.affiliation: Sleep Laboratory, Pulmonary Division, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Geraldo
authors.initials: G
authors.lastname: Lorenzi-Filho
authors.affiliation: Pronto Socorro Cardiológico de Pernambuco (PROCAPE) da Universidade de Pernambuco, and PROCAPE da Universidade de Pernambuco, Pernambuco, Brazil.
authors.forename: Laura O B F
authors.initials: LOBF
authors.lastname: Costa
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D001938:Brazil / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D015994:Incidence; D008875:Middle Aged; D047648:Perimenopause; D017286:Polysomnography; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology*; D059289:Vascular Stiffness / Q000502:physiology*; D014851:Wakefulness / Q000502:physiology*