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Factors affecting blood pressure profile in pre and postmenopausal women with obstructive sleep apnea hypopnea syndrome

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Abstract

Purpose

Obstructive sleep apnea hypopnea syndrome (OSAHS) is an independent risk factor for development of hypertension. Epidemiological surveys have found that risk of cardiovascular diseases increased in postmenopausal women. However, it is not well known about the profiles of hypertension of women with OSAHS in their different reproductive stages. This study aimed to investigate the difference of blood pressure profile between pre and postmenopausal women with OSAHS.

Methods

Women who were tested by polysomnography (PSG) (n = 207) in Ruijin Hospital were recruited in the study. The subjects were divided into two groups of premenopausal women (24 with and 30 without OSAHS), and two groups of postmenopausal women (116 with and 37 without OSAHS). Among the groups, the differences of demographic and PSG variables were compared. The factors influencing blood pressure were further studied.

Results

The prevalence of hypertension (56.9 %) in postmenopausal OSAHS patients was higher than the other three groups. Among OSAHS patients, both average systolic blood pressure (SBP) and diastolic blood pressure (DBP) of postmenopausal women were higher than those of premenopausal ones [(129.9 ± 16.16 mmHg vs. 123.7 ± 18.89), (84.96 ± 9.88 mmHg vs. 78.81 ± 10.34), P = 0.05, P < 0.01, respectively], with the elevation of DBP being more pronounced. For premenopausal women, body mass index (BMI) was the only factor affecting blood pressure (p < 0.05); in postmenopausal women, BMI was a factor affecting SBP, while BMI and apnea hypopnea index (AHI) affecting DBP (P < 0.05).

Conclusion

Blood pressure profile of postmenopausal women with OSAHS was affected by both BMI and AHI. But those of premenopausal ones were predominantly related to BMI.

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References

  1. Kato M, Adachi T, Koshino Y, Somers VK (2009) Obstructive sleep apnea and cardiovascular disease. Circ J 73:1363–1370

    Article  PubMed  Google Scholar 

  2. Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342:1378–1384

    Article  CAS  PubMed  Google Scholar 

  3. Baguet JP, Hammer L, Lévy P, Pierre H, Rossini E, Mouret S, Ormezzano O, Mallion JM, Pépin JL (2005) Night-time and diastolic hypertension are common and underestimated conditions in newly diagnosed apnoeic patients. J Hypertens 23:521–527

    Article  CAS  PubMed  Google Scholar 

  4. Franklin KA, Sahlin C, Stenlund H, Lindberg E (2013) Sleep apnoea is a common occurrence in females. Eur Respir J 41:610–615

    Article  PubMed  Google Scholar 

  5. Gislason T, Benediktsdóttir B, Björnsson JK, Kjartansson G, Kjeld M, Kristbjarnarson H (1993) Snoring, hypertension, and the sleep apnea syndrome. An epidemiologic survey of middle-aged women. Chest 103:1147–1151

    Article  CAS  PubMed  Google Scholar 

  6. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep disordered breathing in middle-age adults. N Engl J Med 328:1230–1235

    Article  CAS  PubMed  Google Scholar 

  7. Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165:1217–1239

    Article  PubMed  Google Scholar 

  8. Corbo GM, Forastiere F, Agabiti N, Baldacci S, Farchi S, Pistelli R, Simoni M, Valente S, Viegi G (2006) Rhinitis and snoring as risk factors for hypertension in post-menopausal women. Respir Med 100:1368–1373

    Article  PubMed  Google Scholar 

  9. Yong T, Finn L, Austin D, Peterson A (2003) Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med 167:1181–1185

    Article  Google Scholar 

  10. Shahar E, Redline S, Yong T, Boland LL, Baldwin CM, Nieto FJ, O’Connor GT, Rapoport DM, Robbins JA (2003) Hormone replacement therapy and sleep-disordered breathing. Am J Respir Crit Care Med 167:1186–1192

    Article  PubMed  Google Scholar 

  11. Reddy Kilim S, Chandala SR (2013) A comparative study of lipid profile and oestradiol in pre- and post-menopausal women. J Clin Diagn Res 7:1596–1598

    PubMed Central  PubMed  Google Scholar 

  12. Ratiani L, Khorava M, Dgebuadze M, Zhvania N, Sanikidze T (2012) The role of estrogens in pathogenesis of age-related arterial hypertension. Georgian Med News (208-209):71-76

  13. American Academy of Sleep Medicine (2005) The international classification of sleep disorders: diagnostic and coding manual, 2nd edn. American Academy of Sleep Medicine, Westchester, pp 165–167

    Google Scholar 

  14. Guidelines Subcommittee (1999) World Health Organization International Society of Hypertension guidelines for the management of hypertension. J Hypertens 17:151–183

    Google Scholar 

  15. Hansen TW, Jeppesen J, Rasmussen S, Ibsen H, Torp-Pedersen C (2005) Ambulatory blood pressure and mortality: a population based study. Hypertension 45:499–504

    Article  CAS  PubMed  Google Scholar 

  16. Haas DC, Foster GL, Nieto FJ, Redline S, Resnick HE, Robbins JA, Young T, Pickering TG (2005) Age-dependent associations between sleep-disordered breathing and hypertension: importance of discriminating between systolic/diastolic hypertension and isolated systolic hypertension in the Sleep Heart Health Study. Circulation 111:614–621

    Article  PubMed  Google Scholar 

  17. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G et al (2007) Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European society if hypertension (ESH) and of the European society of cardiology (ESC). J Hypertens 25:1105–1187

    Article  CAS  PubMed  Google Scholar 

  18. Huang R, Xiao Y, Zhong X, Li M, Huang XZ (2010) Roles of hypertension and serum leptin in obstructive sleep apnea hypopnea syndrome. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 32:157–161

    PubMed  Google Scholar 

  19. Xu Q, Zhang JN, Xiang M, Fu W, Peng Y (2009) Relevance of sleep apnea-associated heart rate variability to morning blood pressure. Zhonghua Yi Xue Za Zhi 89:1815–1819

    PubMed  Google Scholar 

  20. Kanagy NL, Walker BR, Nelin LD (2001) Role of endothelin in intermittent hypoxia-induced hypertension. Hypertension 37:511–515

    Article  CAS  PubMed  Google Scholar 

  21. Altay T, Gonzales ER, Park TS, Gidday JM (2004) Cerebrovascular inflammation after brief episodic hypoxia: modulation by neuronal and endothelial nitric oxide synthase. J Appl Physiol 96:1223–1230

    Article  CAS  PubMed  Google Scholar 

  22. Saaresranta T, Polo O (2003) Sleep-disordered breathing and hormones. Eur Respir J 22:161–172

    Article  CAS  PubMed  Google Scholar 

  23. Netzer NC, Eliasson AH, Strohl KP (2003) Women with sleep apnea have lower levels of sex hormones. Sleep Breath 7:25–29

    Article  PubMed  Google Scholar 

  24. Stavaras C, Pastaka C, Papala M, Gravas S, Tzortzis V, Melekos M, Seitanidis G, Gourgoulianis KI (2012) Sexual function in pre-and post-menopausal women with obstructive sleep apnea syndrome. Int J Impot Res 24:228–233

    Article  CAS  PubMed  Google Scholar 

  25. Mendelsohn ME, Karas RH (1999) The protective effects of estrogen on the cardiovascular system. N Engl J Med 340:1801–1811

    Article  CAS  PubMed  Google Scholar 

  26. Li QY, Huang SG, Li M, Liu JL, Wan HY (2009) BMI is an independent risk factor for snoring in Chinese women aged over 30 years. Sleep Breath 13:289–293

    Article  PubMed  Google Scholar 

  27. Mendelson M, Tamisier R, Laplaud D, Dias-Domingos S, Baguet JP, Moreau L, Koltes C, Chavez L, de Lamberterie G, Herengt F, Levy P, Flore P, Pépin JL (2013) Low physical activity is a determinant for elevated blood pressure in high cardiovascular risk obstructive sleep apnea. Respir Care [PMID: 24282316].

  28. Pujante P, Abreu C, Moreno J, Barrero EA, Azcarate P, Campo A, Urrestarazu E, Silva C, Maria JG, Tebar J, Frühbeck G, Salvador J (2013) Obstructive sleep apnea severity is associated with left ventricular mass independent of other cardiovascular risk factors in morbid obesity. J Clin Sleep Med 9:1165–1171

    PubMed Central  PubMed  Google Scholar 

  29. Chang ET, Yang MC, Wang HM, Lai HL (2013) Snoring in a sitting position and neck circumference are predictors of sleep apnea in Chinese patients. Sleep Breath [PMID: 23677737]

  30. Banhiran W, Junlapan A, Assanasen P, Chongkolwatana C (2013) Physical predictors for moderate to severe obstructive sleep apnea in snoring patients. Sleep Breath [PMID: 23703693].

  31. Mehdad S, Hamrani A, Kari KE, Hamdouchi AE, Mzibri ME, Barkat A, Aguenaou H, Mokhtar N (2013) Prevalence of elevated blood pressure and its relationship with fat mass, body mass index and waist circumference among a group of Moroccan overweight adolescents. Obes Res Clin Pract 7:e235–e320

    Article  Google Scholar 

  32. Tibana RA, Teixeira TG, Farias DL, Silva Ade O, Madrid B, Vieira A, Franz CB, Balsamo S, Souza, Júnior TP, Prestes J (2012) Relation of neck circumference and relative muscle strength and cardiovascular risk factors in sedentary women. Einstein (Sao Paulo) 10:329–334

    Article  Google Scholar 

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Acknowledgments

The study was funded by grants from the National Natural Science Foundation (81070068). None of the authors have any conflict of interest.

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Authors and Affiliations

  1. Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China

    Hua Jun Xu, Xiao Fei Lan, Qing Yun Li, Li Na Zhou, Xiu Juan Zhang, Qian Guo, Jin Hua Ni & Bei Cao

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  1. Hua Jun Xu
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  2. Xiao Fei Lan
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  3. Qing Yun Li
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  4. Li Na Zhou
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  5. Xiu Juan Zhang
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  7. Jin Hua Ni
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  8. Bei Cao
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Correspondence to Qing Yun Li.

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Xu and Lan contributed equally to this article.

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Xu, H.J., Lan, X.F., Li, Q.Y. et al. Factors affecting blood pressure profile in pre and postmenopausal women with obstructive sleep apnea hypopnea syndrome. Sleep Breath 19, 169–174 (2015). https://doi.org/10.1007/s11325-014-0983-z

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  • DOI: https://doi.org/10.1007/s11325-014-0983-z

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