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Determinants of Daytime Blood Pressure in Relation to Obstructive Sleep Apnea in Men

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Abstract

This study investigated the roles of different potential pathophysiological mechanisms in the determination of blood pressure in relation to obstructive sleep apnea. The study was designed as a cross-sectional study. Consecutive healthy male subjects who were to undergo polysomnography were recruited. Demographic and anthropometric data were collected. Blood pressure measurements were taken in the evening before sleep and the next morning on waking. Overnight urinary samples for catecholamines and fasting blood for cortisol, insulin, glucose, and lipids were taken. Ninety-four men were analyzed, with a mean age of 43.7 ± 9.3 years and mean apnea–hypopnea index (AHI) of 27.5 ± 26.2 events/h. Sixty-nine patients (73%) had obstructive sleep apnea (AHI ≥ 5). Urinary catecholamines were positively correlated with severity of sleep apnea, independent of obesity. Blood pressure measurements correlated with age, obesity, severity of sleep apnea, and urinary catecholamines. Regression analysis showed that sleep indices and urinary catecholamines were independent determinants of morning systolic and diastolic blood pressure, respectively, while total cholesterol and waist circumference were respective additional factors. Urinary catecholamines and waist circumference were determinants of evening blood pressure, with morning cortisol being an additional determinant for diastolic blood pressure. Obstructive sleep apnea and related sympathetic activity contributed significantly to the determination of daytime blood pressure in overweight middle-aged men without overt cardiometabolic diseases, and other contributing factors include abdominal obesity, total cholesterol, and cortisol levels.

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Acknowledgment

This study was supported by the Lee Wing Tat Cardiorespiratory Research Fund, Department of Medicine, University of Hong Kong.

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Authors and Affiliations

  1. Department of Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam, Hong Kong SAR, China

    Jamie C. M. Lam, Clara S. W. Yan, Agnes Y. K. Lai, Bing Lam & Mary S. M. Ip

  2. Department of Biochemistry, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China

    Sidney Tam

  3. Medical Statistics Unit, Nursing Studies, The University of Hong Kong, Hong Kong SAR, China

    Daniel Y. T. Fong

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  1. Jamie C. M. Lam
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  2. Clara S. W. Yan
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  6. Bing Lam
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Correspondence to Mary S. M. Ip.

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Lam, J.C.M., Yan, C.S.W., Lai, A.Y.K. et al. Determinants of Daytime Blood Pressure in Relation to Obstructive Sleep Apnea in Men. Lung 187, 291–298 (2009). https://doi.org/10.1007/s00408-009-9161-7

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  • DOI: https://doi.org/10.1007/s00408-009-9161-7

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