Bruno Teixeira Barbosa1,2, Amilton da Cruz Santos1,2,3, Murillo Frazão4, Tulio Rocha Petrucci4, Gabriel Grizzo Cucato5, Adriana Oliveira Sarmento6, Eduardo D S Freitas2, Anna Myrna Jaguaribe de Lima7, Maria do Socorro Brasileiro-Santos8,9,10. 1. Laboratory of Physical Training Studies Applied to Health, Physical Education Department, Universidade Federal da Paraíba (UFPB), João Pessoa, PB, Brazil. 2. Associate Graduate Program in Physical Education UPE/UFPB, João Pessoa, Brazil. 3. Physical Education Departament, Federal University of Paraiba, João Pessoa, PB, Brazil. 4. Lauro Wanderley University Hospital, João Pessoa, PB, Brazil. 5. Israelita Albert Einstein Hospital, São Paulo, SP, Brazil. 6. Heart Institute (InCor), FMUSP, São Paulo, SP, Brazil. 7. Animal Anatomy and Physiology Department, Universidade Federal Rural de Pernambuco, Recife, PE, Brazil. 8. Laboratory of Physical Training Studies Applied to Health, Physical Education Department, Universidade Federal da Paraíba (UFPB), João Pessoa, PB, Brazil. sbrasileiro@pq.cnpq.br. 9. Associate Graduate Program in Physical Education UPE/UFPB, João Pessoa, Brazil. sbrasileiro@pq.cnpq.br. 10. Physical Education Departament, Federal University of Paraiba, João Pessoa, PB, Brazil. sbrasileiro@pq.cnpq.br.
Abstract
BACKGROUND: Elderly people have a high prevalence to systemic arterial hypertension (SAH) and obstructive sleep apnea (OSA). Both comorbidities are closely associated and inflict damage on cardiorespiratory capacity. METHODS: In order to assess cardiorespiratory responses to the cardiopulmonary exercise test (CPET) among hypertensive elderly with OSA, we enrolled 28 subjects into two different groups: without OSA (No-OSA: apnea/hypopnea index (AHI) < 5 events/h; n = 15) and with OSA (OSA: AHI ≥ 15 events/h; n = 13). All subjects underwent CPET and polysomnographic assessments. After normality and homogeneity evaluations, independent t test and Pearson's correlation were performed. The significance level employed was p ≤ 0.05. RESULTS: Hypertensive elderly with OSA presented lower heart rate recovery (HRR) in the second minute (HRR2) in relation to the No-OSA group. A negative correlation between AHI and ventilation (VE) (r = -0.63, p = 0.02) was found in polysomnography and CPET data comparisons, and oxygen saturation (O2S) levels significantly correlated with VE/VCO2slope (r = 0.66, p = 0.01); in addition, OSA group presented a positive correlation between oxygen consumption and O2S (r = 0.60, p = 0.02), unlike the no-OSA group. CONCLUSIONS: OSA does not affect the CPET variables in hypertensive elderly, but it attenuates the HRR2. The association between O2S during sleep with ventilatory responses probably occurs due to the adaptations in the oxygen transport system unleashed via mechanical respiratory feedback; thus, it has been identified that OSA compromises the oxygen supply in hypertensive elderly.
BACKGROUND: Elderly people have a high prevalence to systemic arterial hypertension (SAH) and obstructive sleep apnea (OSA). Both comorbidities are closely associated and inflict damage on cardiorespiratory capacity. METHODS: In order to assess cardiorespiratory responses to the cardiopulmonary exercise test (CPET) among hypertensive elderly with OSA, we enrolled 28 subjects into two different groups: without OSA (No-OSA: apnea/hypopnea index (AHI) < 5 events/h; n = 15) and with OSA (OSA: AHI ≥ 15 events/h; n = 13). All subjects underwent CPET and polysomnographic assessments. After normality and homogeneity evaluations, independent t test and Pearson's correlation were performed. The significance level employed was p ≤ 0.05. RESULTS:Hypertensive elderly with OSA presented lower heart rate recovery (HRR) in the second minute (HRR2) in relation to the No-OSA group. A negative correlation between AHI and ventilation (VE) (r = -0.63, p = 0.02) was found in polysomnography and CPET data comparisons, and oxygen saturation (O2S) levels significantly correlated with VE/VCO2slope (r = 0.66, p = 0.01); in addition, OSA group presented a positive correlation between oxygen consumption and O2S (r = 0.60, p = 0.02), unlike the no-OSA group. CONCLUSIONS: OSA does not affect the CPET variables in hypertensive elderly, but it attenuates the HRR2. The association between O2S during sleep with ventilatory responses probably occurs due to the adaptations in the oxygen transport system unleashed via mechanical respiratory feedback; thus, it has been identified that OSA compromises the oxygen supply in hypertensive elderly.
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