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Influences of obstructive sleep apnea on blood pressure variability might not be limited only nocturnally in middle-aged hypertensive males

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

In this cross-sectional study, we analyzed the potential association between sleep measures and blood pressure variability.

Methods

Ninety-three middle-aged hypertensive males, who underwent polysomnography and 24-h ambulatory blood pressure monitoring, were enrolled. Blood pressure variability was assessed by blood pressure standard deviation. Obstructive sleep apnea (apnea hypopnea index ≥ 15) was diagnosed in 52 (55.91%) patients. Mean body mass index and age were 27.77 ± 3.11 kg/m2 and 44.05 ± 8.07 years, respectively.

Results

Hypertensive males with obstructive sleep apnea showed significantly higher 24-h, diurnal, and nocturnal diastolic blood pressure variability, compared to those without obstructive sleep apnea. While total cohort was further divided into two groups using the median of oxygen desaturation index, another indicator for severity of OSA, significant differences were also observed in 24-h, diurnal, and nocturnal diastolic blood pressure variability between two groups with higher and lower oxygen desaturation index. While subjects were also divided into two groups via the mean of sleep stage 1, hypertensive males with sleep stage 1 ≥ 8.1% showed significantly higher diurnal diastolic blood pressure variability than those with sleep stage 1 < 8.1%. Apnea hypopnea index was independently associated with 24-h and nocturnal diastolic blood pressure variability; oxygen desaturation index of 3% with 24-h diastolic, diurnal, and nocturnal diastolic blood pressure; and sleep stage 1 was with 24-h and with diurnal diastolic blood pressure variability in all study subjects.

Conclusion

Effects of obstructive sleep apnea on blood pressure variability may not be limited nocturnally.

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Abbreviations

AHI:

Apnea/hypopnea index

BMI:

Body mass index

BP:

Blood pressure

BPV:

Blood pressure variability

DBP:

Diastolic blood pressure

ESS:

Epworth sleepiness scale

FBG:

Fasting blood glucose

HbA1C:

hemoglobin A1C

LSaO2 :

Lowest oxyhemoglobin saturation

MAP:

Mean arterial pressure

N1:

Sleep 1 stage

ODI3 :

oxygen desaturation index of 3%

OSA:

Obstructive sleep apnea

PSG:

Polysomnography

SBP:

Systolic blood pressure

SD:

Standard deviation

CPAP:

Continuous positive airway pressure

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Funding

Government of China provided financial support in the form of National Natural Science Foundation (8,360,051 and 8,165,002). The sponsor had no role in the design or conduct of this research.

Author information

Author notes

  1. Liang Shao and Mulalibieke Heizhati equally contributed to this work.

Authors and Affiliations

  1. The Center of Hypertension of the People’s Hospital of Xinjiang Uygur Autonomous Region China, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang China, No. 91 Tianchi Road, Tianshan District, Urumqi, Xinjiang, 830001, China

    Liang Shao, Mulalibieke Heizhati, Xiaoguang Yao, Yingchun Wang, Suofeiya Abulikemu, Delian Zhang, Ling Zhou, Jing Hong & Nanfang Li

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  1. Liang Shao
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  2. Mulalibieke Heizhati
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  3. Xiaoguang Yao
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  5. Suofeiya Abulikemu
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  7. Ling Zhou
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Correspondence to Nanfang Li.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

This study is in accordance with the ethical standards of the institutional and/or National Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Shao, L., Heizhati, M., Yao, X. et al. Influences of obstructive sleep apnea on blood pressure variability might not be limited only nocturnally in middle-aged hypertensive males. Sleep Breath 22, 377–384 (2018). https://doi.org/10.1007/s11325-017-1571-9

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  • DOI: https://doi.org/10.1007/s11325-017-1571-9

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