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

Oreste Marrone,1 Maria R Bonsignore1,2 1National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, 2DiBiMIS, University of Palermo, Palermo, Italy Abstract: Obstructive sleep apnea (OSA) is often associated with hypertension and other cardiovascular diseases. Blood pressu...

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Auteurs principaux:	Marrone O, Bonsignore MR
Format:	article
Langue:	EN
Publié:	Dove Medical Press 2018
Sujets:	sleep apnea ambulatory blood pressure monitoring beat-by-beat measurements blood pressure dipping morning blood pressure surge Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Accès en ligne:	https://doaj.org/article/53ae8c222f434f85aa7448a9aa4062dd
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spelling	oai:doaj.org-article:53ae8c222f434f85aa7448a9aa4062dd2021-12-02T08:06:43ZBlood-pressure variability in patients with obstructive sleep apnea: current perspectives1179-1608https://doaj.org/article/53ae8c222f434f85aa7448a9aa4062dd2018-08-01T00:00:00Zhttps://www.dovepress.com/blood-pressure-variability-in-patients-with-obstructive-sleep-apnea-cu-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Oreste Marrone,1 Maria R Bonsignore1,2 1National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, 2DiBiMIS, University of Palermo, Palermo, Italy 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 antihypertensive pharmacological therapy and treatment of apnea. Addressing BP variability could help improve the management of OSA and reduce cardiovascular risk. Possibly, drug administration at an appropriate time would ensure a dipping-BP profile. Keywords: sleep apnea, ambulatory blood-pressure monitoring, beat-by-beat measurements, blood-pressure dipping, morning blood-pressure surgeMarrone OBonsignore MRDove Medical Pressarticlesleep apneaambulatory blood pressure monitoringbeat-by-beat measurementsblood pressure dippingmorning blood pressure surgePsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 10, Pp 229-242 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	sleep apnea ambulatory blood pressure monitoring beat-by-beat measurements blood pressure dipping morning blood pressure surge Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	sleep apnea ambulatory blood pressure monitoring beat-by-beat measurements blood pressure dipping morning blood pressure surge Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Marrone O Bonsignore MR Blood-pressure variability in patients with obstructive sleep apnea: current perspectives
description	Oreste Marrone,1 Maria R Bonsignore1,2 1National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, 2DiBiMIS, University of Palermo, Palermo, Italy 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 antihypertensive pharmacological therapy and treatment of apnea. Addressing BP variability could help improve the management of OSA and reduce cardiovascular risk. Possibly, drug administration at an appropriate time would ensure a dipping-BP profile. Keywords: sleep apnea, ambulatory blood-pressure monitoring, beat-by-beat measurements, blood-pressure dipping, morning blood-pressure surge
format	article
author	Marrone O Bonsignore MR
author_facet	Marrone O Bonsignore MR
author_sort	Marrone O
title	Blood-pressure variability in patients with obstructive sleep apnea: current perspectives
title_short	Blood-pressure variability in patients with obstructive sleep apnea: current perspectives
title_full	Blood-pressure variability in patients with obstructive sleep apnea: current perspectives
title_fullStr	Blood-pressure variability in patients with obstructive sleep apnea: current perspectives
title_full_unstemmed	Blood-pressure variability in patients with obstructive sleep apnea: current perspectives
title_sort	blood-pressure variability in patients with obstructive sleep apnea: current perspectives
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/53ae8c222f434f85aa7448a9aa4062dd
work_keys_str_mv	AT marroneo bloodpressurevariabilityinpatientswithobstructivesleepapneacurrentperspectives AT bonsignoremr bloodpressurevariabilityinpatientswithobstructivesleepapneacurrentperspectives
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Blood-pressure variability in patients with obstructive sleep apnea: current perspectives

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