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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Autores principales: Marrone O, Bonsignore MR
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Publicado: Dove Medical Press 2018
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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
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