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Diastolic dysfunction in controlled hypertensive patients with mild-moderate obstructive sleep apnea
Elisabetta Lisi1, Andrea Faini2, Grzegorz Bilo3
1Dept. of Health Sciences, University of Milano-Bicocca, Milan, Italy; Dept. of Cardiology, S. Luca Hospital, Istituto Auxologico Italiano, Milan, Italy.
International Journal of Cardiology
|April 26, 2015
Summary
Mild-moderate obstructive sleep apnea (OSA) in hypertensive patients is linked to early diastolic dysfunction. Nocturnal hypoxia, exacerbated by hypertension and OSA, appears to be a key factor.
Area of Science:
- Cardiology
- Sleep Medicine
- Hypertension Research
Background:
- Hypertension and severe obstructive sleep apnea (OSA) are known contributors to left ventricular diastolic dysfunction.
- Limited data exists on the impact of mild-moderate OSA on diastolic function in hypertensive individuals.
Purpose of the Study:
- To investigate the association between mild-moderate OSA and left ventricular diastolic dysfunction in treated essential hypertensives.
- To identify factors contributing to diastolic dysfunction in this patient group.
Main Methods:
- Polysomnography, echocardiography, and 24-hour ambulatory blood pressure monitoring were conducted in 91 treated essential hypertensives.
- Patients were categorized into mild-moderate OSA (apnea-hypopnea index 5-30 events/h) and no OSA groups.
- Diastolic function parameters (E, A, E') and nocturnal oxygen saturation (SpO2) were assessed.
Main Results:
- Mild-moderate OSA was diagnosed in 47.3% of patients.
- Patients with mild-moderate OSA exhibited higher heart rate and lower E/A ratios compared to non-OSA patients.
- Lower mean SpO2 correlated with impaired diastolic function (E'<10 cm/s, E/A<0.8).
Conclusions:
- Mild-moderate OSA is associated with early diastolic dysfunction in controlled hypertensives, independent of age, gender, BMI, and blood pressure.
- Nocturnal hypoxia emerges as a significant factor in developing diastolic dysfunction, synergistically influenced by hypertension and mild-moderate OSA.
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