TY - JOUR
T1 - Determinants of daytime blood pressure in relation to obstructive sleep apnea in men
AU - Lam, Jamie C.M.
AU - Yan, Clara S.W.
AU - Lai, Agnes Y.K.
AU - Tam, Sidney
AU - Fong, Daniel Y.T.
AU - Lam, Bing
AU - Ip, Mary S.M.
N1 - Funding Information:
This study was supported by the Lee Wing Tat Cardiorespiratory Research Fund, Department of Medicine, University of Hong Kong.
PY - 2009/10
Y1 - 2009/10
N2 - This study investigated the roles of different potential pathophysiological mechanisms in the determination of blood pressure in relation to obstructive sleep apnea. The study was designed as a cross-sectional study. Consecutive healthy male subjects who were to undergo polysomnography were recruited. Demographic and anthropometric data were collected. Blood pressure measurements were taken in the evening before sleep and the next morning on waking. Overnight urinary samples for catecholamines and fasting blood for cortisol, insulin, glucose, and lipids were taken. Ninety-four men were analyzed, with a mean age of 43.7 ± 9.3 years and mean apnea-hypopnea index (AHI) of 27.5 ± 26.2 events/h. Sixty-nine patients (73%) had obstructive sleep apnea (AHI ≥5). Urinary catecholamines were positively correlated with severity of sleep apnea, independent of obesity. Blood pressure measurements correlated with age, obesity, severity of sleep apnea, and urinary catecholamines. Regression analysis showed that sleep indices and urinary catecholamines were independent determinants of morning systolic and diastolic blood pressure, respectively, while total cholesterol and waist circumference were respective additional factors. Urinary catecholamines and waist circumference were determinants of evening blood pressure, with morning cortisol being an additional determinant for diastolic blood pressure. Obstructive sleep apnea and related sympathetic activity contributed significantly to the determination of daytime blood pressure in overweight middle-aged men without overt cardiometabolic diseases, and other contributing factors include abdominal obesity, total cholesterol, and cortisol levels.
AB - This study investigated the roles of different potential pathophysiological mechanisms in the determination of blood pressure in relation to obstructive sleep apnea. The study was designed as a cross-sectional study. Consecutive healthy male subjects who were to undergo polysomnography were recruited. Demographic and anthropometric data were collected. Blood pressure measurements were taken in the evening before sleep and the next morning on waking. Overnight urinary samples for catecholamines and fasting blood for cortisol, insulin, glucose, and lipids were taken. Ninety-four men were analyzed, with a mean age of 43.7 ± 9.3 years and mean apnea-hypopnea index (AHI) of 27.5 ± 26.2 events/h. Sixty-nine patients (73%) had obstructive sleep apnea (AHI ≥5). Urinary catecholamines were positively correlated with severity of sleep apnea, independent of obesity. Blood pressure measurements correlated with age, obesity, severity of sleep apnea, and urinary catecholamines. Regression analysis showed that sleep indices and urinary catecholamines were independent determinants of morning systolic and diastolic blood pressure, respectively, while total cholesterol and waist circumference were respective additional factors. Urinary catecholamines and waist circumference were determinants of evening blood pressure, with morning cortisol being an additional determinant for diastolic blood pressure. Obstructive sleep apnea and related sympathetic activity contributed significantly to the determination of daytime blood pressure in overweight middle-aged men without overt cardiometabolic diseases, and other contributing factors include abdominal obesity, total cholesterol, and cortisol levels.
KW - Conventional risk factors
KW - Daytime blood pressure
KW - Obstructive sleep apnea
KW - Sympathetic activity
UR - http://www.scopus.com/inward/record.url?scp=70349240253&partnerID=8YFLogxK
U2 - 10.1007/s00408-009-9161-7
DO - 10.1007/s00408-009-9161-7
M3 - Article
C2 - 19653037
AN - SCOPUS:70349240253
SN - 0341-2040
VL - 187
SP - 291
EP - 298
JO - Lung
JF - Lung
IS - 5
ER -
