N.А. Krushynska, Yu.М. Sirenko. Changes of arterial compliance and stiffness in patients with arterial hypertension and obstructive sleep apnea syndrome.

The aim – to assess arterial compliance and stiffness in patients with arterial hypertension (AH) and obstructive sleep apnea (OSA).

Material and methods. Eighty-two consecutive hypertensive patients with OSA and 24 hypertensive patients without OSA (50.94±2.56) were enrolled in the study. They underwent clinical and ambulatory blood pressure measurements, echocardiography, unattended somnography by dual-channel portable monitor device, applanation tonometry and estimation of daily sleepiness by Epworth Sleepiness Scale. Carotid-femoral (PWVcf) and carotid-radial pulse wave velocity, central aortic pressure (CAP), left ventricular hypertrophy, blood pressure data and level of daily sleepiness were assessed.

Results. In subjects with OSA higher PWVcf (11.94±0.58 m/s vs 10.18±0.44 m/s without OSA, Р<0.02) and central aortic pressure (134.59±2.63 vs 127.04±2.50 mm Hg without OSA, Р<0.05) were revealed. The levels of daily sleepiness (12.24±1.25 vs 7.46±0.85 without OSA, Р<0.01) and body mass index (36.94±1.67 kg/m2 in severe OSA vs 31.29±0.98 kg/m2 in controls and 31.95±1.19 kg/m2 in mild OSA, Р<0.01, Р<0.05 respectively) were greater in hypertensive patients with severe OSA. Patients with moderate OSA have significantly higher level of CAP compared to mild OSA and controls (138.82±2.18 vs 130.30±2.21 and 127.04±4.50 mm Hg, Р<0.02, Р<0.005 respectively). It was established that 24-hour SAP (147.47±4.43 mm Hg in severe OSA vs 132.33±3.23 mm Hg in mild OSA, Р<0.01) and 24-hour DAP (88.34±2.97 mm Hg in severe OSA vs 80.26±1.64 mm Hg in moderate OSA, Р<0.05) in severe OSA were significantly higher. Conclusions. Significantly worse indices of arterial stiffness, higher degree of central aortic pressure and higher level of BMI and daily sleepiness were revealed in patients with severe OSA.

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