title: Recurrence of stroke caused by nocturnal hypoxia-induced blood pressure surge in a young adult male with severe obstructive sleep apnea syndrome.
abstract: Obstructive sleep apnea syndrome (OSAS) causes resistant hypertension and a hypopnea-related nocturnal blood pressure (BP) surge. This could lead to an increase of not only the nocturnal BP level but also nocturnal BP variability, both of which increase an individual's cardiovascular risk. We recently developed a trigger sleep BP monitoring method that initiates BP measurement when an individual's oxygen desaturation falls below a variable threshold, and we demonstrated that it can detect a BP surge during apnea episodes. We here report the case of a 36-year-old man with severe OSAS who experienced the recurrence of stroke due to nocturnal hypoxia and a nocturnal BP surge measured by this trigger sleep BP monitoring device. A nocturnal BP surge during sleep in OSAS patients could be a strong trigger of cardiovascular events.
authors.affiliation: Department of Cardiovascular of Medicine, Onga Nakama Medical Association, Onga Hospital, Fukuoka, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan; Department of Sleep and Circadian Cardiology, Jichi Medical University School of Medicine, Tochigi, Japan.
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Kuwabara
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan; Department of Sleep and Circadian Cardiology, Jichi Medical University School of Medicine, Tochigi, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hoshide
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan; Department of Sleep and Circadian Cardiology, Jichi Medical University School of Medicine, Tochigi, Japan. Electronic address: kkario@jichi.ac.jp.
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kario
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D000860:Hypoxia / Q000150:complications* / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D017286:Polysomnography; D020146:Putaminal Hemorrhage / Q000000981:diagnostic imaging; D012008:Recurrence; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology*
chemical_list: D000959:Antihypertensive Agents
keywords: Nocturnal blood pressure surge; obstructive sleep apnea syndrome