CHARACTERISTICS OF NOCTURNAL HYPERTENSION IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA

Objective: To evaluate the relationship between obstructive sleep apnea and nocturnal arterial hypertension (NAHT) in hypertensive patients. To investigate correlations between BP (blood pressure) and apnea hypopnea indexes (AHI). Design and method: 433 selected nocturnal hypertensive patients with sleep-disordered breathing (SDB) including sleep apnea with a mean age of 59.2±11 years. Sustained hypertension (68%) and masked hypertension (32% including 21% isolated nocturnal hypertension). Statistical analysis using SPSS version 25 software also enabled comparison with non-NAHT patients. Study of the influence of SDB on ambulatory blood pressure (BP) measurement parameters (BP, nocturnal BP dips and BP variability) using correlations (Spearman). Results: Patients with systolic and diastolic NAHT have the highest AHI and desaturation values compared with patients without NAHT. The majority of NAHT patients have a nycthemeral status of “no dipper or riser”. There was a correlation between the AHI and nocturnal diastolic BP (DBP) (r=0.314 p=0.02) and between the desaturation index and nocturnal DBP (r=0.290 p=0.003). Negative correlations between SBP and DBP dips and SDB indices: AHI and systolic BP (SBP): r=-0.288 p=0.08 and SDI and SBP: r=-0.369 p=0.012 AHI and DBP: r=-0.310 p=0.02 and SDI and DBP: r=-0.324 p=0.011.A correlation between SDB indexes and nocturnal DBP variability (ARV): SDI and diastolic ARV(r=0.425 p=0.01) and index of microarousals and ARV(r=0.434 p=0.001). Conclusions: nocturnal arterial hypertension and obstructive sleep apnea represent a major cardiovascular risk. Early management of nycthemeral BP variations and control of sleep apnea are top priorities to avoid morbimortal complications.