Arousals Are Frequent and Associated With Exacerbated Blood Pressure Response in Patients With Primary Hypertension

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art_GARCIA_Arousals_Are_Frequent_and_Associated_With_Exacerbated_Blood_2013.PDF (946.5 KB)
Citações na Scopus
13
Tipo de produção
article
Data de publicação
2013
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
OXFORD UNIV PRESS
Autores
UENO, Linda M.
Citação
AMERICAN JOURNAL OF HYPERTENSION, v.26, n.5, p.617-623, 2013
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
BACKGROUND Spontaneous arousals are relatively common during sleep, and induce hemodynamic responses. We sought to investigate the frequency and magnitude of blood pressure (BP) increases triggered by spontaneous arousals in patients with primary hypertension. METHODS We conducted a study in which we divided 18 nonobese, sedentary adults without sleep-disordered breathing into two groups, consisting of: (i) hypertensive (HT, n = 8) patients; and (ii) normotensive (NT, n = 10) controls. The groups were matched for age and body mass index. All subjects underwent full polysomnography with simultaneous monitoring of heart rate (HR) and beat-by-beat BR Each subject's BP and HR were analyzed immediately before BP peaks triggered by spontaneous arousals during stage 2 of nonrapid eye movement sleep. RESULTS The total sleep time, sleep efficiency, and sleep structure in the two study groups were similar. In contrast, the number of arousals was significantly higher in the HT than in the NT group, at 25 +/- 5 vs. 12 +/- 3 events/h, respectively (P < 0.05). The HR of the HT and NT groups was similar before arousal (65 +/- 3 bpm vs. 67 +/- 3 bpm, respectively, P < 0.01) and increased significantly and similarly in the two groups upon arousal (to 79 +/- 6 bpm vs. 74 +/- 4 bpm, respectively, P < 0.01). Systolic and diastolic BPs were significantly higher throughout sleep in the HT than in the NT group. During spontaneous arousals, BP increased in both groups (P < 0.05). However, the magnitude of the increase in systolic BP was significantly greater in the HT than in the NT group (22 +/- 3 mm Hg vs. 15 +/- 3 mm Hg, P < 0.05). CONCLUSIONS Patients with hypertension who do not have sleep-disordered breathing have an increased cardiovascular burden during sleep, which may be due to the greater number of arousals and exacerbated systolic BP response that they experience during sleep. These novel findings may have cardiovascular implications in patients with hypertension.
Palavras-chave
spontaneous arousal, sleep, hypertension, blood pressure
URI
https://observatorio.fm.usp.br/handle/OPI/1809
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/09