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Characteristics and predictors of obstructive sleep apnea in patients with systemic hypertension.
Am J Cardiol. 2010 Apr 15; 105(8):1135-9.AJ

Abstract

Obstructive sleep apnea (OSA) is a secondary cause of hypertension and independently associated with target-organ damage in hypertensive patients. However, OSA remains largely underdiagnosed and undertreated. The aim of the present study was to evaluate the characteristics and clinical predictors of OSA in a consecutive series of patients followed up in a hypertension unit. A total of 99 patients (age 46 + or - 11 years, body mass index 28.8 kg/m(2), range 25.1 to 32.9) underwent polysomnography. The clinical parameters included age, gender, obesity, daytime sleepiness, snoring, Berlin Questionnaire, resistant hypertension, and metabolic syndrome. Of the 99 patients, 55 (56%) had OSA (apnea-hypopnea index >5 events/hour). Patients with OSA were older and more obese, had greater levels of blood pressure, and presented with more diabetes, dyslipidemia, resistant hypertension, and metabolic syndrome than the patients without OSA. Of the patients with OSA, 51% had no excessive daytime sleepiness. The Berlin Questionnaire and patient age revealed a high sensitivity (0.93 and 0.91, respectively) but low specificity (0.59 and 0.48, respectively), and obesity and resistant hypertension revealed a low sensitivity (0.58 and 0.44, respectively) but high specificity (0.75 and 0.91, respectively) for OSA. Metabolic syndrome was associated with high sensitivity and specificity for OSA (0.86 and 0.85, respectively). Multiple regression analysis showed that age of 40 to 70 years (odds ratio 1.09, 95% confidence interval 1.03 to 1.16), a high risk of OSA on the Berlin Questionnaire (odds ratio 8.36, 95% confidence interval 1.67 to 41.85), and metabolic syndrome (odds ratio 19.04, 95% confidence interval 5.25 to 69.03) were independent variables associated with OSA. In conclusion, more important than the typical clinical features that characterize OSA, including snoring and excessive daytime sleepiness, the presence of the metabolic syndrome is as an important marker of OSA among patients with hypertension.

Authors+Show Affiliations

Hypertension Unit, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, São Paulo, Brazil. luciano.drager@incor.usp.brNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20381666

Citation

Drager, Luciano F., et al. "Characteristics and Predictors of Obstructive Sleep Apnea in Patients With Systemic Hypertension." The American Journal of Cardiology, vol. 105, no. 8, 2010, pp. 1135-9.
Drager LF, Genta PR, Pedrosa RP, et al. Characteristics and predictors of obstructive sleep apnea in patients with systemic hypertension. Am J Cardiol. 2010;105(8):1135-9.
Drager, L. F., Genta, P. R., Pedrosa, R. P., Nerbass, F. B., Gonzaga, C. C., Krieger, E. M., & Lorenzi-Filho, G. (2010). Characteristics and predictors of obstructive sleep apnea in patients with systemic hypertension. The American Journal of Cardiology, 105(8), 1135-9. https://doi.org/10.1016/j.amjcard.2009.12.017
Drager LF, et al. Characteristics and Predictors of Obstructive Sleep Apnea in Patients With Systemic Hypertension. Am J Cardiol. 2010 Apr 15;105(8):1135-9. PubMed PMID: 20381666.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics and predictors of obstructive sleep apnea in patients with systemic hypertension. AU - Drager,Luciano F, AU - Genta,Pedro R, AU - Pedrosa,Rodrigo P, AU - Nerbass,Flávia B, AU - Gonzaga,Carolina C, AU - Krieger,Eduardo M, AU - Lorenzi-Filho,Geraldo, Y1 - 2010/02/20/ PY - 2009/10/16/received PY - 2009/12/01/revised PY - 2009/12/01/accepted PY - 2010/4/13/entrez PY - 2010/4/13/pubmed PY - 2010/6/16/medline SP - 1135 EP - 9 JF - The American journal of cardiology JO - Am J Cardiol VL - 105 IS - 8 N2 - Obstructive sleep apnea (OSA) is a secondary cause of hypertension and independently associated with target-organ damage in hypertensive patients. However, OSA remains largely underdiagnosed and undertreated. The aim of the present study was to evaluate the characteristics and clinical predictors of OSA in a consecutive series of patients followed up in a hypertension unit. A total of 99 patients (age 46 + or - 11 years, body mass index 28.8 kg/m(2), range 25.1 to 32.9) underwent polysomnography. The clinical parameters included age, gender, obesity, daytime sleepiness, snoring, Berlin Questionnaire, resistant hypertension, and metabolic syndrome. Of the 99 patients, 55 (56%) had OSA (apnea-hypopnea index >5 events/hour). Patients with OSA were older and more obese, had greater levels of blood pressure, and presented with more diabetes, dyslipidemia, resistant hypertension, and metabolic syndrome than the patients without OSA. Of the patients with OSA, 51% had no excessive daytime sleepiness. The Berlin Questionnaire and patient age revealed a high sensitivity (0.93 and 0.91, respectively) but low specificity (0.59 and 0.48, respectively), and obesity and resistant hypertension revealed a low sensitivity (0.58 and 0.44, respectively) but high specificity (0.75 and 0.91, respectively) for OSA. Metabolic syndrome was associated with high sensitivity and specificity for OSA (0.86 and 0.85, respectively). Multiple regression analysis showed that age of 40 to 70 years (odds ratio 1.09, 95% confidence interval 1.03 to 1.16), a high risk of OSA on the Berlin Questionnaire (odds ratio 8.36, 95% confidence interval 1.67 to 41.85), and metabolic syndrome (odds ratio 19.04, 95% confidence interval 5.25 to 69.03) were independent variables associated with OSA. In conclusion, more important than the typical clinical features that characterize OSA, including snoring and excessive daytime sleepiness, the presence of the metabolic syndrome is as an important marker of OSA among patients with hypertension. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/20381666/Characteristics_and_predictors_of_obstructive_sleep_apnea_in_patients_with_systemic_hypertension_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(09)02847-1 DB - PRIME DP - Unbound Medicine ER -