Blood pressure response to treatment of obese vs non-obese adults with sleep apnea.
Arterial Pressure
/ physiology
Blood Pressure
/ physiology
Blood Pressure Monitoring, Ambulatory
/ methods
Body Mass Index
Case-Control Studies
Continuous Positive Airway Pressure
/ methods
Female
Humans
Iceland
/ epidemiology
Intra-Abdominal Fat
/ growth & development
Male
Middle Aged
Norepinephrine
/ urine
Obesity
/ complications
Sleep Apnea, Obstructive
/ metabolism
Sympathetic Nervous System
/ physiopathology
Waist Circumference
/ physiology
blood pressure
continuous positive airway pressure
norepinephrine in urine
obstructive sleep apnea
Journal
Journal of clinical hypertension (Greenwich, Conn.)
ISSN: 1751-7176
Titre abrégé: J Clin Hypertens (Greenwich)
Pays: United States
ID NLM: 100888554
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
11
05
2019
revised:
13
07
2019
accepted:
22
07
2019
pubmed:
19
9
2019
medline:
22
10
2020
entrez:
19
9
2019
Statut:
ppublish
Résumé
Many patients with obstructive sleep apnea (OSA), but not all, have a reduction in blood pressure (BP) with positive airway pressure (PAP) treatment. Our objective was to determine whether the BP response following PAP treatment is related to obesity. A total of 188 adults with OSA underwent 24-hour BP monitoring and 24-hour urinary norepinephrine collection at baseline. Obesity was assessed by waist circumference, body mass index, and abdominal visceral fat volume. Participants adherent to PAP treatment were reassessed after 4 months. Primary outcomes were 24-hour mean arterial pressure (MAP) and 24-hour urinary norepinephrine level. Obstructive sleep apnea participants had a significant reduction in 24-hour MAP following PAP treatment (-1.22 [95% CI: -2.38, -0.06] mm Hg; P = .039). No significant correlations were present with any of the 3 obesity measures for BP or urinary norepinephrine measures at baseline in all OSA participants or for changes in BP measures in participants adherent to PAP treatment. Changes in BP measures following treatment were not correlated with baseline or change in urinary norepinephrine. Similar results were obtained when BP or urinary norepinephrine measures were compared between participants dichotomized using the sex-specific median of each obesity measure. Greater reductions in urinary norepinephrine were correlated with higher waist circumference (rho = -0.21, P = .037), with a greater decrease from baseline in obese compared to non-obese participants (-6.26 [-8.82, -3.69] vs -2.14 [-4.63, 0.35] ng/mg creatinine; P = .027). The results indicate that the BP response to PAP treatment in adults with OSA is not related to obesity or urinary norepinephrine levels.
Identifiants
pubmed: 31532580
doi: 10.1111/jch.13689
pmc: PMC8030424
doi:
Substances chimiques
Norepinephrine
X4W3ENH1CV
Types de publication
Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1580-1590Subventions
Organisme : NHLBI NIH HHS
ID : P01 HL094307
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
©2019 Wiley Periodicals, Inc.
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