BACKGROUND: Obstructive sleep apnea (OSA) increases the risk for mild hypertension, but its relationship to refractory hypertension (RHT) has not been systematically examined. We previously reported a high prevalence of OSA in patients with RHT, but did not have a control group with which to compare. Rapid eye movement (REM) sleep deprivation can raise blood pressure in animals. However, a potential relationship of OSA and REM sleep time with RHT has not been examined. OBJECTIVE: To determine whether, compared with patients with well controlled hypertension, those with RHT have a higher prevalence of OSA (apnea-hypopnea index > or = 10 per hour of sleep) and shorter REM sleep time. METHODS: We compared the prevalence of OSA and sleep structure in 42 patients with RHT with 22 patients with controlled hypertension, matched for age, sex and BMI. RESULTS: Compared with the controlled hypertension group, the RHT group had a significantly higher prevalence of OSA (81 versus 55%, P = 0.03) and less REM sleep time (47.0 +/- 4.5 versus 63.2 +/- 4.9 min, P = 0.02). Multivariate analysis revealed significantly increased odds of having RHT associated with OSA independent of other risk factors (adjusted odds ratio, 3.994; 95% confidence interval, 1.191-13.388). Reduced REM sleep time was also independently associated with the presence of RHT (adjusted odds ratio, 1.025; 95% confidence interval, 1.002-1.049). CONCLUSION: OSA and reduced REM sleep time are associated with increased odds of having RHT and, therefore, may play roles in its pathogenesis.
BACKGROUND:Obstructive sleep apnea (OSA) increases the risk for mild hypertension, but its relationship to refractory hypertension (RHT) has not been systematically examined. We previously reported a high prevalence of OSA in patients with RHT, but did not have a control group with which to compare. Rapid eye movement (REM) sleep deprivation can raise blood pressure in animals. However, a potential relationship of OSA and REM sleep time with RHT has not been examined. OBJECTIVE: To determine whether, compared with patients with well controlled hypertension, those with RHT have a higher prevalence of OSA (apnea-hypopnea index > or = 10 per hour of sleep) and shorter REM sleep time. METHODS: We compared the prevalence of OSA and sleep structure in 42 patients with RHT with 22 patients with controlled hypertension, matched for age, sex and BMI. RESULTS: Compared with the controlled hypertension group, the RHT group had a significantly higher prevalence of OSA (81 versus 55%, P = 0.03) and less REM sleep time (47.0 +/- 4.5 versus 63.2 +/- 4.9 min, P = 0.02). Multivariate analysis revealed significantly increased odds of having RHT associated with OSA independent of other risk factors (adjusted odds ratio, 3.994; 95% confidence interval, 1.191-13.388). Reduced REM sleep time was also independently associated with the presence of RHT (adjusted odds ratio, 1.025; 95% confidence interval, 1.002-1.049). CONCLUSION: OSA and reduced REM sleep time are associated with increased odds of having RHT and, therefore, may play roles in its pathogenesis.
Authors: Khaled Abdel-Kader; Sheena Dohar; Nirav Shah; Manisha Jhamb; Steven E Reis; Patrick Strollo; Daniel Buysse; Mark L Unruh Journal: J Hypertens Date: 2012-05 Impact factor: 4.844
Authors: Macy M S Lui; H F Tse; Judith C W Mak; David C L Lam; Carmen W S Chan; Peony W C Chong; Mary S M Ip Journal: J Clin Sleep Med Date: 2018-11-15 Impact factor: 4.062
Authors: Costas Thomopoulos; Helena Michalopoulou; Alexandros Kasiakogias; Anna Kefala; Thomas Makris Journal: Int J Hypertens Date: 2011-01-10 Impact factor: 2.420