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Hypertension Research
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Diurnal Blood Pressure Variation in Patients with Sleep Apnea Syndrome
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  • Original Article
  • Published: 01 February 2008

Diurnal Blood Pressure Variation in Patients with Sleep Apnea Syndrome

  • Kohei Nagata1,
  • Naohiko Osada2,
  • Minako Shimazaki1,
  • Keisuke Kida2,
  • Kihei Yoneyama2,
  • Ayako Tsuchiya2,
  • Takashi Yasuda1 &
  • …
  • Kenjiro Kimura1 

Hypertension Research volume 31, pages 185–191 (2008)Cite this article

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Abstract

Sleep apnea syndrome (SAS) is an important risk factor for hypertension and cardiovascular diseases. Diurnal blood pressure (BP) changes are evaluated by 24 h ambulatory blood pressure monitoring (ABPM). The purpose of this study was to clarify the relationship between diurnal BP variation and SAS severity, as well as the impact of antihypertensive therapy on diurnal BP variation. Patients seen at our clinic between April and September 2006 with excessive daytime sleepiness or apnea were enrolled. All patients had polysomnography and ABPM. Mean 24 h BP and nighttime BPs were significantly higher in the SAS group than in the non-SAS group. No significant differences were observed in daytime BPs between the two groups. SAS patients had a high mean 24-h BP and an elevated nighttime BP, both of which increased as SAS severity increased. Nighttime BPs were significantly higher in the moderate SAS group than in the non-SAS group. Nighttime BP and morning BP were significantly higher in the severe SAS group than in the non-SAS group. With respect to antihypertensive agents' effects on diurnal BP changes, there were no significant differences between the SAS and non-SAS groups. In conclusion, compared with non-SAS patients, patients with SAS had a higher 24-h BP, especially nighttime BP. Patients with moderate SAS tended to have elevated nighttime BP. In patients with severe SAS, elevated BP was sustained during the night despite the use of antihypertensive agents.

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References

  1. Yaggi HK, Concato J, Kernan WN, et al: Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005; 353: 2034–2041.

    Article  CAS  Google Scholar 

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

    Article  CAS  Google Scholar 

  3. Nieto FJ, Young TB, Lind BK, et al: Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 2000; 283: 1829–1836.

    Article  CAS  Google Scholar 

  4. Suzuki M, Guilleminault C, Otsuka K, et al: Blood pressure “dipping” and “non-dipping” in obstructive sleep apnea syndrome patients. Sleep 1996; 19: 382–387.

    Article  CAS  Google Scholar 

  5. Davies CW, Crosby JH, Mullins RL, et al: Case-control study of 24 hour ambulatory blood pressure in patients with obstructive sleep apnoea and normal matched control subjects. Thorax 2000; 55: 736–740.

    Article  CAS  Google Scholar 

  6. Marsh EE 3rd, Biller J, Adams HP Jr, et al: Circadian variation in onset of acute ischemic stroke. Arch Neurol 1990; 47: 1178–1180.

    Article  Google Scholar 

  7. Goldberg RJ, Brady P, Muller JE, et al: Time of onset of symptoms of acute myocardial infarction. Am J Cardiol 1990; 66: 140–144.

    Article  CAS  Google Scholar 

  8. Kario K, Pickering TG, Umeda Y, et al: Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives: a prospective study. Circulation 2003; 107: 1401–1406.

    Article  Google Scholar 

  9. Rechtschaffen A, Kales A : Manual of Standardized Technology, Techniques and Scoring System for Sleep Stage of Human Subjects. Los Angeles, Brain Information Service, Brain Research Institute, UCLA, 1968.

    Google Scholar 

  10. Kario K, Pickering TG, Matsuo T, et al: Stroke prognosis and abnormal nocturnal blood pressure falls in older hypertensives. Hypertension 2001; 38: 852–857.

    Article  CAS  Google Scholar 

  11. Narkiewicz K, van de Borne PJ, Cooley RL, et al: Sympathetic activity in obese subjects with and without obstructive sleep apnea. Circulation 1998; 98: 772–776.

    Article  CAS  Google Scholar 

  12. Parati G, Di Rienzo M, Bonsignore MR, et al: Autonomic cardiac regulation in obstructive sleep apnea syndrome: evidence from spontaneous baroreflex analysis during sleep. J Hypertens 1997; 15: 1621–1626.

    Article  CAS  Google Scholar 

  13. Ip MS, Tse HF, Lam B, et al: Endothelial function in obstructive sleep apnea and response to treatment. Am J Respir Crit Care Med 2004; 169: 348–353.

    Article  Google Scholar 

  14. Moller DS, Lind P, Strunge B, et al: Abnormal vasoactive hormones and 24-hour blood pressure in obstructive sleep apnea. Am J Hypertens 2003; 16: 274–280.

    Article  CAS  Google Scholar 

  15. Shamsuzzaman AS, Winnicki M, Lanfranchi P, et al: Elevated C-reactive protein in patients with obstructive sleep apnea. Circulation 2002; 105: 2462–2464.

    Article  CAS  Google Scholar 

  16. Larkin EK, Rosen CL, Kirchner HL, et al: Variation of C-reactive protein levels in adolescents: association with sleep-disordered breathing and sleep duration. Circulation 2005; 111: 1978–1984.

    Article  CAS  Google Scholar 

  17. Yamauchi M, Nakano H, Maekawa J, et al: Oxidative stress in obstructive sleep apnea. Chest 2005; 127: 1674–1679.

    Article  CAS  Google Scholar 

  18. Kario K : Time for focus on morning hypertension: pitfall of current antihypertensive medication. Am J Hypertens 2005; 18: 149–151.

    Article  Google Scholar 

  19. Pankow W, Nabe B, Lies A, et al: Influence of sleep apnea on 24-hour blood pressure. Chest 1997; 112: 1253–1258.

    Article  CAS  Google Scholar 

  20. Campos-Rodriguez F, Grilo-Reina A, Perez-Ronchel J, et al: Effect of continuous positive airway pressure on ambulatory BP in patients with sleep apnea and hypertension: a placebo-controlled trial. Chest 2006; 129: 1459–1467.

    Article  Google Scholar 

  21. Becker HF, Jerrentrup A, Ploch T, et al: Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation 2003; 107: 68–73.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan

    Kohei Nagata, Minako Shimazaki, Takashi Yasuda & Kenjiro Kimura

  2. Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan

    Naohiko Osada, Keisuke Kida, Kihei Yoneyama & Ayako Tsuchiya

Authors
  1. Kohei Nagata
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  2. Naohiko Osada
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  3. Minako Shimazaki
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  4. Keisuke Kida
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  5. Kihei Yoneyama
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  6. Ayako Tsuchiya
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  7. Takashi Yasuda
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  8. Kenjiro Kimura
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Corresponding author

Correspondence to Kohei Nagata.

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Nagata, K., Osada, N., Shimazaki, M. et al. Diurnal Blood Pressure Variation in Patients with Sleep Apnea Syndrome. Hypertens Res 31, 185–191 (2008). https://doi.org/10.1291/hypres.31.185

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  • Received: 31 May 2007

  • Accepted: 13 August 2007

  • Issue date: 01 February 2008

  • DOI: https://doi.org/10.1291/hypres.31.185

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Keywords

  • sleep apnea syndrome
  • diurnal blood pressure variation
  • antihypertensive agents

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