OSA Is Common and Independently Associated With Hypertension and Increased Arterial Stiffness in Consecutive Perimenopausal Women

被引:42
作者
Pedrosa, Rodrigo P. [1 ]
Barros, Isly M. L. [1 ,2 ]
Drager, Luciano F. [3 ]
Bittencourt, Marcio S. [4 ]
Medeiros, Ana Kelley L. [1 ]
Carvalho, Liana L.
Lustosa, Thais C.
Carvalho, Martinha M. B.
Ferreira, Moacir N. L. [1 ]
Lorenzi-Filho, Geraldo [3 ]
Costa, Laura O. B. F. [2 ]
机构
[1] PROCAPE Univ Pernambuco, Sleep & Heart Lab, Recife, PE, Brazil
[2] PROCAPE Univ Pernambuco, Pernambuco, Brazil
[3] Univ Sao Paulo, Fac Med, Hosp Clin, Div Pulm,Heart Inst InCor,Sleep Lab, Sao Paulo, Brazil
[4] Univ Sao Paulo, Univ Hosp, Sao Paulo, Brazil
关键词
OBSTRUCTIVE SLEEP-APNEA; POSITIVE AIRWAY PRESSURE; CORONARY-HEART-DISEASE; CARDIOVASCULAR MORTALITY; INCREASED PREVALENCE; GENDER-DIFFERENCES; BLOOD-PRESSURE; ALL-CAUSE; RISK; MEN;
D O I
10.1378/chest.14-0097
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
BACKGROUND: Perimenopause is associated with increased cardiovascular risk. OSA is an emerging risk factor for cardiovascular disease, particularly among men, but the independent contribution of OSA to cardiovascular risk in climacteric women is not clear. METHODS: We evaluated 277 consecutive women (age, 56 [52-61] years; BMI, 28 [25-32] kg/m(2)) without manifest cardiovascular disease (heart failure, coronary disease, or stroke). All women underwent 24-h ambulatory BP monitoring, arterial stiffness evaluation (pulse wave velocity), and portable sleep study. RESULTS: OSA (apnea-hypopnea index >= 5 events/h) and moderate to severe OSA (apnea-hypopnea index >= 15 events/h) were diagnosed in 111(40.1%) and 31 (11.1%) women, respectively. None of the participants had received a previous diagnosis of OSA. Women with moderate to severe OSA vs those without OSA had a higher prevalence of hypertension, were prescribed more medications for hypertension, had higher awake BP (systolic, 133 [125-142] vs 126 [119-134] mm Hg [ P < .01]; diastolic, 82 [78-88] vs 79 [74-85] mm Hg [P = .07]), higher nocturnal BP (systolic, 125 [118-135] vs 115 [109-124] mm Hg [P < .01]; diastolic, 73 [69-79] vs 69 [62-75] mm Hg [P < .01]), and more arterial stiffness (pulse wave velocity, 11.5 [10.1-12.3] m/s vs 9.5 [8.6-10.8] m/s, P < .001). Oxygen desaturation index during the night was independently associated with 24-h arterial BP and arterial stiffness (per five-unit increase in oxygen desaturation index, beta = 1.30 [95% CI, 0.02-2.54; P = .04] vs 0.22 [95% CI, 0.03-0.40; P = .02] in women with vs without OSA, respectively). CONCLUSIONS: OSA is common, underdiagnosed, and independently associated with high BP and increased arterial stiffness in perimenopausal women.
引用
收藏
页码:66 / 72
页数:7
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