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The effects of obstructive sleep apnea on blood pressure variability and load in patients with hypertension

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Background

Hypertension frequently coexists with obstructive sleep apnea (OSA), and their interplay substantially impacts the prognosis of affected individuals. Investigating the influence of OSA on blood pressure variability (BPV) and blood pressure load (BPL) in hypertensive patients has become a focal point of clinical research.

Methods

This cross-sectional study recruited hypertensive patients (n = 265) without discrimination and classified them into four groups based on their apnea–hypopnea index (AHI): control group (n = 40), AHI < 5; mild group (n = 74), 5 ≤ AHI ≤ 15; moderate group (n = 68), 15 < AHI ≤ 30; severe group (n = 83), AHI > 30. All participants underwent comprehensive assessments, including polysomnography (PSG) monitoring, 24-h ambulatory blood pressure (ABP) monitoring, cardiac Doppler ultrasound, and additional examinations when indicated.

Results

BPV and BPL exhibited significant elevations in the moderate and severe OSA groups compared to the control and mild OSA groups (P < 0.05). Moreover, interventricular septum thickness and left ventricular end-diastolic volume (LVEDV) demonstrated higher values in the moderate and severe OSA groups (P < 0.05). Multiple stepwise regression analysis identified noteworthy risk factors for elevated BPV in hypertensive patients with OSA, including AHI, maximum apnea time, total times of oxygen reduction, and mean time of apnea.

Conclusion

Hypertensive patients with moderate to severe OSA exhibited substantially increased BPV and BPL. Moreover, BPV was correlated with AHI, maximum apnea time, total times of oxygen reduction, and mean time of apnea in hypertensive patients with OSA.

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Data availability

The data and materials used and/or analyzed in this study are available from the corresponding author on reasonable request.

Abbreviations

OSA:

Obstructive sleep apnea

ABP:

Ambulatory blood pressure

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

MAP:

Mean arterial pressure

BPV:

Blood pressure variability

BPL:

Blood pressure load

SBPL:

Systolic blood pressure load

DBPL:

Diastolic blood pressure load

AHI:

Apnea-hypopnea index

PSG:

Polysomnography

BP:

Blood pressure

BMI:

Body mass index

ORI:

Oxygen reduction index

AI:

Apnea index

HI:

Hypoventilation index

SSD:

Standard deviation of systolic pressure

DSD:

Standard deviation of diastolic pressure

LVEF:

Left ventricular function

LVEDV:

Left ventricular end-diastolic volume

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Acknowledgements

The authors would like to thank all the participants in this study.

Author information

Authors and Affiliations

  1. Department of Cardiology, The Third Affiliated Hospital of Anhui Medical University, Hefei, 230001, Anhui Province, China

    Shao-dong Xu

  2. Department of Sleep Monitoring Center, The Third Affiliated Hospital of Anhui Medical University, Hefei, 230001, Anhui Province, China

    Ling-li Hao & Fei-fei Liu

  3. Department of Electrocardiogram, The Third Affiliated Hospital of Anhui Medical University, Hefei, 230001, Anhui Province, China

    Chuan-zhi Xu

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  1. Shao-dong Xu
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Contributions

Shaodong Xu: substantial contributions to the conception, design, analysis, drafting of the work, collecting data, analyzing data, and revising it critically for important intellectual content. Lingli Hao: contributions to conduct PSG examination on patients, analyzes data, and issues PSG report. Feifei Liu: contributions to conduct PSG examination on patients, analyzes data, and issues PSG report. Chuanzhi Xu: contributions to conduct ABP examination on patients, analyzes data, and issues ABP report. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Shao-dong Xu.

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Ethics approval

All procedures performed in studies involving human participants were 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. This research was approved by the Ethics Committee of the Third Affiliated Hospital of Anhui Medical University.

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The written informed consent was obtained from all of the patients before the procedure.

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The authors declare no competing interests.

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Xu, Sd., Hao, Ll., Liu, Ff. et al. The effects of obstructive sleep apnea on blood pressure variability and load in patients with hypertension. Sleep Breath (2024). https://doi.org/10.1007/s11325-024-03005-4

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