title: Impact of non-dipping on cardiovascular outcomes in patients with obstructive sleep apnea syndrome.
abstract: Obstructive sleep apnea syndrome (OSAS) is a risk factor for cardiovascular events. However, it is unclear how OSAS contributes to the events. We investigated the impact of non-dipping on the incidence of cardiovascular events in a retrospective cohort study comprising 251 patients with OSAS. OSAS was diagnosed by overnight polysomnography and all patients underwent 24-h ambulatory blood pressure monitoring. Non-dipping was diagnosed when reduction in sleep blood pressure was <10% of awake blood pressure. Over a mean 43-month follow-up period, 15 patients (6.0%) developed cardiovascular events including stroke, heart failure, and ischemic heart disease. Significantly higher cardiovascular events were observed in the non-dipping group than those without it by Kaplan-Meier analyses. Cox regression analysis revealed that the presence of non-dipping was significantly and independently associated with the incidence of cardiovascular events (hazard ratio, 3.88; 95% confidence interval, 1.19-17.41; p < 0.05), after adjusting for severity of OSAS, and CPAP therapy. Thus, non-dipping was a marker for a poor prognosis in patients with OSAS.
authors.affiliation: a Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council , Hiroshima , Japan .
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sasaki
authors.affiliation: b Department of General Medicine , Hiroshima University Graduate School of Biomedical and Health Sciences , Hiroshima , Japan .
authors.forename: Ryoji
authors.initials: R
authors.lastname: Ozono
authors.affiliation: c Department of Clinical Laboratories , Mitsubishi Mihara Hospital , Mihara , Japan .
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Edahiro
authors.affiliation: c Department of Clinical Laboratories , Mitsubishi Mihara Hospital , Mihara , Japan .
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Ishii
authors.affiliation: c Department of Clinical Laboratories , Mitsubishi Mihara Hospital , Mihara , Japan .
authors.forename: Ayako
authors.initials: A
authors.lastname: Seto
authors.affiliation: c Department of Clinical Laboratories , Mitsubishi Mihara Hospital , Mihara , Japan .
authors.forename: Tomomi
authors.initials: T
authors.lastname: Okita
authors.affiliation: d Department of Internal Medicine , Mitsubishi Mihara Hospital , Mihara , Japan , and.
authors.forename: Kazushi
authors.initials: K
authors.lastname: Teramen
authors.affiliation: a Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council , Hiroshima , Japan .
authors.forename: Saeko
authors.initials: S
authors.lastname: Fujiwara
authors.affiliation: e Department of Cardiovascular Medicine , Hiroshima University Graduate School of Biomedical and Health Sciences , Hiroshima , Japan.
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Kihara
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012189:Retrospective Studies; D012307:Risk Factors; D012890:Sleep / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology; D015996:Survival Rate / Q000639:trends
keywords: Ambulatory blood pressure monitoring; cardiovascular risk factors; hypertension; non-dipping; sleep apnea