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Orta Yaş Hipertansif Bireylerde Kan Basıncı Kontrolü ve Uyku Kalitesi Arasındaki İlişkinin Analizi

An Analysis of The Relation Between Blood Pressure Regulatıon and Sleep Quality in Middle Aged Hypertensıve Subjects

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Abstract (2. Language): 
In the present study, we aimed to evaluate the effect of blood pressure regulation on sleep quality in the hypertensive subjects and determine blood pressure parameters related with poor sleep quality. Our study is a cross-sectional study including 90 hypertensive subjects at age between 35 and 65 years. The patients were performed 24-hour ambulatory blood pressure monitoring and divided into those with regulated blood pressure group and poor blood pressure control group. Sleep quality was checked before the ambulatory blood pressure monitoring by using Pittsburgh sleep quality test. Statistical analyses were performed with SPSS 13.0 packet program. Global Pittsburgh sleep quality index (PSQI) scoring were similar in both groups and when components of the sleep quality were evaluated, daytime dysfunction was significantly higher in patients with poor blood pressure control compared to patienst with regulated blood pressure (1.0±0.9 versus 1.4±1.0, p=0.05; respectively ). Global PSQI score did not show significant correlation with arterial blood pressure leveles, pulse pressure, and systolic blood pressure levels. However, night diastolic pressure levels were weakly correlated with global PSQI scoring (r=0.16, p=0.04). Only diastolic non-dipper status was found as independent predictor of poor sleep quality as a result of logistic regression analysis (Odds: 3.21 (CI: 1.51-7.72), p=0.03). In the present study, sleep quality was markedly impaired in hypertensive patients and diastolic non-dipper was determined as an independent predictor of poor sleep quality. It seems important to assess sleep quality in patient with diastolic non-dipper at ambulatuary blood pressure evaluation, especially for detection of poor sleep status.
Abstract (Original Language): 
Bu çalışmada orta yaş hipertansif hastalarda kan basıncı regülasyonun uyku kalitesi üzerine etkisini ve kötü uyku kalitesi ile ilişkili kan basıncı parametrelerin neler olduğunu belirlemeyi amaçladık Çalışmamız yaşları 35 ile 65 arasında değişen 90 hipertansif hastanın alındığı kesitsel bir çelışmadır. Hastalara 24 saatlik ambulatuvar kan basıncı holteri takılarak kan basıncı ortalamalarına göre hastalar regüle KB olanlar ve kötü KB kontrolü olanlar olarak iki gruba ayrılmıştır. Uyku kalitesi ambulatuvar kan basıncı holteri takılmadan önce Pittsburgh uyku kalitesi testi ile değerlendirildi. İstatistiksel analiz için SPSS 13.0 paket programı kullanıldı. Global Pittsburgh uyku kalite indeksi(PSQI) skoru her iki grupta benzerdi ve uyku kalitesinin bileşenleri incelendiğinde yalnız gündüz işlev bozukluğu kötü kan basıncı kontrolü grubunda anlamlı olarak artmıştı (1,0±0,9 ve 1,4±1,0 p=0.05 ). Global PSQI skoru ile ortalama arteriyal kan basıncı, nabız basıncı, sistolik kan basıncı arasında korelasyon tespit edilmedi, gece diyastolik KB ile zayıf korelasyon mevcuttu(r=0.16 p=0.04). Kötü uyku kalitesinin öngördürücülerini tespit etmek için yapılan lojistik regresyon analizinde yalnızca diyastolik non-dipper durumunun bozulmuş uyku kalitesi açısından bağımsız öngördürücü olduğu tespit edildi(odds 3,21(CI: 1,51-7,72) p=0.03) Çalışmamızda hipertansif hastalarda uyku kalitesinin belirgin şekilde bozulduğu, diyastolik non-dipper’in bozulmuş uyku kalitesi açısından bağımsız öngördürücü olduğu tespit edilmiştir. Ambulatuvar KB ölçümlerinde diyastolik non-dipper tespit edilen hastalarda uyku kalitesinin sorgulanması, bu hastalarda uyku bozukluğunu tespiti açısından önemli görünmektedir
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REFERENCES

References: 

1. Maquet P. The role of sleep in learning and memory. Science
2001;294:1048–52)
2. Belenky G, Wesensten NJ, Thorne DR, Thomas ML, Sing HC,
Redmond DP et al. Patterns of performance degradation and
restoration during sleep restriction and subsequent recovery: a
sleep dose-response study. J Sleep Res 2003;12:1–12
3. Spiegel K, Leproult R, Van Cauter E. Impact of sleep debt on
metabolic and endocrine function. Lancet 1999;354:1435–9
4. Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep
duration is associated with reduced leptin, elevated ghrelin,
and increased body mass index. PLoS Med 2004;1:e62, Hasler
G, Buysse D, Klaghofer R, et al. The association between
short sleep duration and obesity in young adults: a 13-year
prospective study. Sleep 2004;27:661–6
5. Sonne-Holm S, Sorensen TI, Jensen G Schnohr P. Independent
effects of weight change and attained body weight on
prevalence of arterial hypertension in obese and non-obese
men. BMJ 1989; 299(6702):767–70
6. Kojima M, Wakai K, Kawamura T, Tamakoshi A, Aoki R, Lin Y et
al. Sleep patterns and total mortality: a 12-year follow-up study
in Japan. J Epidemiol 2000;10:87–93
7. Nieto, F.J, Young, T.B, Lind, B.K, Shahar E,Samet JM, Redline
S et al. . Association of sleep-disordered breathing, sleep
apnea, and hypertension in a large community-based study.
Sleep Heart Health Study. Journal of the American Medical
Association, 2000; 283, 1829-36.
8. Lusardi P, Zoppi A, Preti P, Pesce RM, Piazza E, Fogari R.
Effects of insufficient sleep in blood pressure in hypertensive
patients: A 24 hour study. American Journal of Hypertension,
1999; 12, 63-68.
9. M.B. Yilmaz, A. Erdem, K. Yalta, O.O. Turgut, A Yılmaz, I
Tandoğan. Impact of beta-blockers on sleep in patients with
mild hypertension: a randomized trial between nebivolol and
metoprolol, Adv Ther 2008;25, 871–883.
10. Dimsdale J.E. Reflections on the impact of antihypertensive
medications on mood, sedation, and neuropsychologic
functioning. Arch Intern Med. 1992;152(1):35-9.
11. Fagard RH, Thijs L, Staessen JA, Clement DL, De Buyzere ML,
De Bacquer DA. Prognostic significance of ambulatory blood
pressure in hypertensive patients with history of cardiovascular
disease. Blood Press Monit. 2008;13(6):325-32
12. Fagard RH, Celis H. Prognostic significance of various
characteristics of out-of-the-office blood pressure. J Hypertens.
2004; 22: 1663–1666.
13. Fagard RH, Thijs L, Staessen JA, Clement DL, De Buyzere ML,
De Bacquer DA. Night-day blood pressure ratio and dipping
pattern as predictors of death and cardiovascular events in
hypertension. J Hum Hypertens. 2009;23(10):645-53..
14. Muxfeldt ES, Cardoso CR, Salles GF. Prognostic value of
nocturnal blood pressure reduction in resistant hypertension.
Arch Intern Med. 2009;169(9):874-80.
15. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA,
Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella
EJ and the National High Blood Pressure Education Program
Coordinating Committee. The seventh report of the Joint
National Committee on Prevention, Detection, Evaluation, and
Treatment of High Blood Pressure. The JNC 7 Report. JAMA.
2003; 289: 2560–2572.
16. Buysse, D.J, Reynolds 3rd C.F, Monk, T.H, Berman SR, Kupfer
DJ. The Pittsburgh Sleep Quality Index: a New Instrument
for Psychiatric Practice and Research. Journal of Psychiatric
Research, 1989;28 (2), 193-213.
17. Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM,
Kreier F, Pickering TG et al. Short sleep duration as a risk
factor for hypertension: analyses of the first National Health and
Nutrition Examination Survey. Hypertension 2006;47(5):833–9.
18. Gottlieb DJ, Redline S, Nieto FJ, Baldwin CM, Newman
AB, Resnick HE et al. Association of usual sleep duration
with hypertension: the Sleep Heart Health Study. Sleep
2006;29(8):1009–14.
19. Houyez F, Degoulet P, Cittee J, Fouriaud C, Jacquinet-Salord
MC, Lang T et al. Sleep and hypertension. An epidemiologic
study in 7,901 workers. Arch Mal Coeur Vaiss 1990;83(8):1085–
8.
20. Kotani K, Saiga K, Sakane N, Mu H, Kurozawa Y. Sleep
status and blood pressure in a healthy normotensive female
population. Int J Cardiol 2007;125(3):425–7.
21. Knutson KL, Van Cauter E, Rathouz PJ, Yan LL, Hulley SB, Liu
K, Lauderdale DS et al. Association between sleep and blood
pressure in mid life: The CARDIA Sleep Study. Arch Intern Med.
2009 June 8; 169(11): 1055–1061.
22. Pickering TG, Kario K. Nocturnal non-dipper: What does it
augur? Curr Opin Nephrol Hypertens. 2001;10:611–616.
23. Yılmaz M.B, Yalta K, Turgut O.O, Yılmaz A. Sleep quality
among relatively younger patients with initial diagnosis of
hypertension: Dippers versus non-dippers. Blood Pressure.
2007; 16: 101–105
24. Mansoor GA. Sleep actigraphy in hypertensive patients with
the ‘non-dipper’ blood pressure profile. Journal of Human
Hypertension 2002; 16, 237–242
25. Bremner AD. Antihypertensive medication and quality of life
– silent treatment of a silent killer? Cardiovasc Drugs Ther.
2002;16:353-364
26. Betts TA, Alford C. Beta-blockers and sleep: a controlled trial.
Eur J Clin Pharmacol. 1985;28:S65-S68.
27. Redline S, Kirchner HL, Quan SF, Gotlieb DJ, Kapur V,
Nevman A. The effects of age, sex, ethnicity, and sleepdisordered breathing on sleep architecture. Arch Intern Med
2004;164:406–18
28. Diane S. L. Kristen L. K. Lijing L. Y. Paul J. R. Objectively
Measured Sleep Characteristics among Early-Middle-Aged
Adults The CARDIA Study. Am J Epidemiol 2006;164:5–16
29. Van Den Berg JF, Tulen JH, Neven AK, Hofman A, Miedema
HM, Witteman JC et al. Sleep duration and hypertension are
not associated in the elderly. Hypertension 2007;50(3):585–9.
30. Lima-Costa MF, Peixoto SV, Rocha FL. Usual sleep duration
is not associated with hypertension in Brazilian elderly: The
Bambui Health Aging Study (BHAS). Sleep Med 2008;9(7):806–
7.

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