Blood-pressure variability in patients with obstructive sleep apnea: current perspectives

Nature and Science of Sleep
Oreste Marrone, Maria R Bonsignore

Abstract

Obstructive sleep apnea (OSA) is often associated with hypertension and other cardiovascular diseases. Blood pressure (BP) variability is part of the assessment of cardiovascular risk. In OSA, BP variability has been studied mainly as very short-term (beat-by-beat) and short-term (24-hour BP profile) variability. BP measured on consecutive heartbeats has been demonstrated to be highly variable, due to repeated peaks during sleep, so that an accurate assessment of nocturnal BP levels in OSA may require peculiar methodologies. In 24-hour recordings, BP frequently features a "nondipping" profile, ie, <10% fall from day to night, which may increase cardiovascular risk and occurrence of major cardiovascular events in the nocturnal hours. Also, BP tends to show a large "morning BP surge", a still controversial negative prognostic sign. Increased very short-term BP variability, high morning BP, and nondipping BP profile appear related to the severity of OSA. Treatment of OSA slightly reduces mean 24-hour BP levels and nocturnal beat-by-beat BP variability by abolishing nocturnal BP peaks. In some patients OSA treatment turns a nondipping into a dipping BP profile. Treatment of arterial hypertension in OSA usually requires both antihyp...Continue Reading

Citations

Feb 28, 2019·Multidisciplinary Respiratory Medicine·Maria R BonsignoreOreste Marrone
May 18, 2019·The European Respiratory Journal·Esther Sapiña-BeltránUNKNOWN Spanish Sleep and Breathing Group
Mar 9, 2019·American Journal of Respiratory and Critical Care Medicine·Emer Van RyswykR Doug McEvoy
Apr 2, 2020·Frontiers in Physiology·Richard StaatsCristina Bárbara
Sep 19, 2019·The Journal of Clinical Hypertension·Kazuomi KarioJi-Guang Wang
Apr 6, 2019·Current Hypertension Reports·Gianfranco ParatiCarolina Lombardi
Mar 20, 2020·Internal and Emergency Medicine·Maria Rosaria BonsignoreEnrico Clini
Sep 19, 2020·European Cardiology·Francesco P Cappuccio
Oct 23, 2020·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Amrita PalPaul M Macey
Feb 23, 2021·Hypertension·Nour MakaremMarwah Abdalla
Jul 3, 2021·Diagnostics·Bala S C KoritalaDavid F Smith

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