Buradasınız

OSAS’lı Hastalarda Cinsiyetin Hipertansiyon Üzerine Etkisi

The Effect of Gender on Hypertension in OSAS Patients

Journal Name:

Publication Year:

Abstract (2. Language): 
Objective: There are limited data about the effect of gender on the tension and rate pressure product (RPP) in patients with OSAS. The aim of the present study was to explore the effect of gender on hypertension (HT) and RPP in patients with OSAS. Methods: A diagnostic polysomnography was performed in all patients for overnight. OSAS diagnosed patients were included in this study. Sleep stages and respiratory events were manually scored. According to the findings of polysomnography, the effect of gender on tension in patients with OSAS was statistically analyzed. Results: Three hundred fourty seven patients consisting of 280 males and 67 females with OSAS were included in the present study. The mean age was 50±15 years in females and 48±12 years in males. The body mass index (BMI) was 28±6 kg/m2 in females and 28±5 kg/m2 in males. There was a positive correlation between the apnea/hypopnea index (AHI) with max systolic blood pressure (SBP) and RPP (p<0.01) in the male group, and a positive correlation between AHI with min PTT in the female group (p<0.01); however, there was no correlation between AHI and max SBP in females (p>0.05). Conclusion: The present study confirms previous findings of a relationship between obstructive sleep apnea with SBP. This relationship was evident in males but not identifiable in these females.These data suggest a possible gender difference in susceptibility to hypertension development in OSAS.
Abstract (Original Language): 
Amaç: Bu çalışmada OSAS’lı hastalarda hipertansiyon ve RPP (rate pressure product) üzerinde cinsiyetin etkilerini araştırmayı amaçladık. Metod: Tüm hastalara bir gece boyunca diagnostik polisomnografi uygıulandı. OSAS teşhisi konulan hastalar çalışmaya dahil edildi. Uyku süreçleri ve respiratuar durumlar polisomnografi bulgularına göre skorlandı. OSAS’lı hastalarda cinsiyetin tansiyon üzerindeki etkileri istatiksel olarak analiz edildi. Bulgular: Çalışmaya 280 erkek ve 67 kadın olmak üzere 347 hasta dahil edildi. Kadınlarda yaş ortalaması 50±15, erkeklerde 48±12’idi. Vücut kitle indeksi (The body mass index (BMI)) kadınlarda 28±6 kg/m² , erkeklerde 28±5 kg/m² olarak bulundu. Burada erkek gruplarında maksimum sistolik kan basıncı ve RPP ile AHI (apnea/hypopnea index) arasında pozitif bir ilişki (p<0.01), kadın gruplarında ise min PTT ile AHI arasında pozitif bir ilişki bulundu (p<0.01); ancak kadınlarda max SBP ile AHI arasında ilşki bulunamadı. Sonuç: Bu çalışma SBP ile obstruktif sleep apne arasındaki ilişkiye ilişkin önceki bulguları doğrulamaktadır. Bu ilişki erkeklerde açık olarak görülürken kadınlarda bulunamamıştır. Bu bilgiler OSAS’lı hastalarda hipertansiyona yatkınlıkta cinsiyet farklılıklarının etkisinin olası olduğunu göstermektedir
85-90

REFERENCES

References: 

1. Phillipson EA: Sleep apnea, in Braunwald E, Fauci AS, Kasper
DL, Hauser SL, Longo DL, Jameson JL (eds) Harrison’s
Principles of Internal Medicine, 15th ed. New York, McGraw-
Hill, 2001, 1520-23.
2. Partinen M, Jamieson A, Guilleminault. C Long–term outcome
for obstructive sleep apnea syndrome patients: mortality. Chest
1988;94:1200-04.
3. Peppard PE, Young T, Palta M, Skatrud J. Prospective study of
the association between sleep-disordered breathing and
hypertension. N Engl J Med 2000;342:1378-84.
4. Shepard JW. Hypertansion, cardiac arrhythmias, myocardial
infarction, and stroke in relation to obstructive sleep apnea. Clin
Chest Med 1992;13:437-58.
5. Wolk R, Kara T, Somers VK. Sleep–disordered breathing
and cardiovascular diseases. Circulation 2003;108:9-12.
6. Zwillich C, Sinoway L. Surges of muscle sympathetic
nerve activity during obstructive apnea are linked to
hypoxemia. J Appl Physiol 1995;79:581-88.
7. Somers VK, Kyken ME, Clary MP, Abbound FM.
Sympathetic neural mechanisms in obstructive sleep
apnea. J Clin Invest 1995;96:1897-1904.
8. Jelic S, Bartels MN, Mateika JH, Ngai P, DeMeersman
RE, Basner RC. Arterial stiffness increases during
obstructive sleep apneas. Sleep 2002 ;25:15-20.
9. Lovett JK, Rothwell PM. Site of carotid plaque ulceration
in relation to direction of blood flow: an angiographic and
pathological study. Cerebrovasc Dis 2003; 16:369-75.
10. Silverberg DS, Oksenberg A. Are sleep related breathing
disorders important contributing factors to the production
of essential hypertension? Curr Hypertens Rep
2001;3:209-15.
11. Gobel FL, Norstrom LA, Nelson RR, Jorgensen CR,
Wang Y. The rate–pressure product as an index of
myocardial oxygen consumption during exercise in
patients with angina pectoris. Circulation 1978; 57: 549–
56.
12. Rechtschaffen A. In AE Kales (ed). A Manual of
Standardized Terminology, Techniques and Scoring
Systems for Sleep Stages of Human Subjects. BIS/BRI
UCLA, Los Angeles, CA;1968.
13. Thorpy M, Committee ftDCS. The International
Classification of Sleep Disorders: Diagnostic and Coding
Manuel. Rochester MN, American Sleep Disorders
Association;1990.
14. Weber, Hypertension medicine. Totowa, N, J. Humana
2001.
15. YH Chan: Biostatistics Correlational Analysis. Singapore
Med J 2003;44(12) : 614-19.
16. Guilleminault C, Connolly SJ, Winkle RA. Cardiac
arrhythmia and conduction disturbances during sleep in
400 patients with sleep apnea syndrome. Am J Cardiol
1983; 52: 490-94.
17. Köhler U, Fus E, Grimm W, et al. Heart block in patients
with obstructive sleep apnea: Pathogenetic factors and
effects of treatment. Eur Respi J 1998;11:434-39.
18. Bayram NK, Çiftçi B, Güven SF, Bayram H, Diker E.
Obstrüktif uyku apne sendromu şiddeti ile hipertansiyon
arasındaki ilişki. Anadolu Kardiyol Derg 2007;7: 378-82
19. Lindberg E, Janson C, Gislason T, Svärdsudd K, Hetta J,
Boman G. Snoring and hypertension: a 10 year follow up.
Eur Respir J 1998;11:884-89.
20. Hedner J, Bengtsson-Boström K, Peker Y, Grote L,
Råstam L, Lindblad U. Hypertension prevalence in
obstructive sleep apnoea and sex: a population-based casecontrol
study. Eur Respir J. 2006;27(3):564-70.
21. Yukawa K, Inoue Y, Yagyu H, Hasegawa T, Komada Y,
Namba K,Nagai N, Nemoto S, Sano E, Minoru M, at
al.Gender on Hypertension in OSAS Patients
Characteristics Among Japanese Patients With
Obstructive Sleep Apnea Syndrome. Chest 2009;135:337-
43.
22. Henly PJ, George CF, Millar TW, Kryger MH. Heart rate
response to breath-hold, valsalva and Mueller maneuvers
in obstructive sleep apnea syndrome. Chest 1989;95;735-
39.
23. Hedner J, Ejnell H, Sellgren J, Hedner T, Wallin G. Is
high and fluctuating muscle nerve sympathetic activity in
the sleep apnoea syndrome of pathogenetic importance
for the development of hypertension? J Hypertens Suppl.
1988;6(4):529-31.
24. Roche F, Court-Fortune I, Pichot V, Duverney D, Costes
F, Emonot A, Vergnon J M, Geyssant A, Lacour J R..
Reduced cardiac sympathetic autonomic tone after longterm
nasal continuous positive airway pressure in obstructive sleep apnoea syndrome. Clin Physiol
1999;19(2):127-134.
25. Philips B: Sleep-disordered breathing and cardiovascular
disease. Sleep Med Rev 2005;9:131-140.
26. Roux F, Ambrosio CD, Mohsenin V. Sleep related
breathing disoreders and cardiovascular diseases. Am J
Med 2000;108:396-402.
27. Kim JS, Song WH, Shin C, Park CG, Seo HS, Shim WJ.
The prevalence and awareness of hypertension and the
relationship between hypertension and snoring in the
Korean population. Korean J Intern Med 2001;16:62-68.
28. Mohsenin V, Yaggi HK, Shah N, Dziura J. The effect of
gender on the prevalence of hypertension in obstructive
sleep apnea. Sleep Med Aug 2009;10(7):759-62.
29. Hedner J, Ejnell H, Caidahl K. Left ventricular
hypertrophy independent of hypertension in patients with
obstructive sleep apnoea. J Hypertens 1990;8:941-46.
30. Kraiczi H, Peker Y, Caidahl K, Samuelsson A, Hedner J.
Blood pressure, cardiac structure and severity of
obstructive sleep apnea in a sleep clinic population. J
Hypertens 2001;19: 2071-78.
31. Yakut T, Karkucak M, Ursavas A, Gulten T, Burgazlioglu
B, Gorukmez O andKaradag M. Lack of association of
ACE gene I/D polymorphism with obstructive sleep
apnea syndrome in Turkish patients. Genetics and
Molecular Research. 2010; 9 (2): 734-38.
32. Noda A, Okada T, Yasuma F, Nakashima N, Yokota M.
Cardiac hypertrophy in obstructive sleep apnea syndrome.
Chest 1995;107: 1538-44.

Thank you for copying data from http://www.arastirmax.com