Arterial hypertension, obstructive sleep apnea and cardiovascular risk

Background. Arterial hypertension (AH) is one of the common causes of cardiovascular and cerebrovascular diseases. Obstructive sleep apnea (OSA) often coexists with AH and increases cardiovascular risk of these patients. The purpose of the study was to assess the cardiovascular risk factors in patients with AH and OSA. Materials and methods. 185 hypertensive patients (average age 49.79 ± 0.80 years) were enrolled in the study and consequently divided into groups: those with OSA (n = 148) and without it (controls, n = 37). They underwent clinical and special examination: somnography by dual-channel portable monitor device, estimation of daily sleepiness by Epworth Sleepiness Scale, office and ambulatory blood pressure measurements, biochemical examination, echocardiography, applanation tonometry with evaluation of central blood pressure and pulse wave velocity. Results. Patients with AH and OSA (mean apnea-hypopnea index 38.08 ± 2.51/h) had significantly higher body mass index — 35.23 ± 0.57 kg/m2 vs 30.57 ± 0.79 kg/m2 (р < 0.001), glucose level — 5.95 ± 0.12 mmol/l vs 5.44 ± ± 0.14 mmol/l (р = 0.045), diabetes mellitus II type rate — 16.9 vs 2.0 % (р < 0.02), uric acid level — 367.16 ± 8.45 µmol/l vs 329.79 ± 17.70 µmol/l (р = 0.048), left ventricular myocardial mass index — 115.79 ± 2.39 g/m2 vs 104.64 ± 4.56 g/m2 (р = 0.035), higher carotid-femoral pulse wave velocity — 11.19 ± ± 0.20 m/s vs 10.10 ± 0.41 m/s (р = 0.014) and central systolic blood pressure — 133.43 ± 1.67 mm Hg vs 125.22 ± 3.40 mm Hg (р = 0.027) vs controls (apnea-hypopnea index 3.02 ± 0.25/h). In OSA patients, uric acid level was associated with increased systolic blood pressure in relation to male sex (r = 0.218, p = 0.013), higher blood levels of creatinine (r = 0.237, p = 0.007) and triglycerides (r = 0.237, p = 0.007), as well as arterial stiffness expressed in terms of Aix75 (r = –0.270. p = 0.003). Conclusions. Patients with AH and OSA had a significantly higher number of cardiometabolic risk factors, by which adverse effects of OSA are realized in patients with AH.