Impact of sleep disorders on hypertension: a multifaceted approach

• Grant number: 19/23496-8
• Support Opportunities: Research Projects - Thematic Grants
• Start date: July 01, 2020
• End date: June 30, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Luciano Ferreira Drager
• Grantee: Luciano Ferreira Drager
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated researchers: Andrea Pio de Abreu ; Geraldo Lorenzi Filho ; Gerhardus Hermanus Maria Schoorlemmer ; Giovanio Vieira da Silva ; Isabela Judith Martins Bensenor ; Madson Queiroz Almeida ; Paulo Andrade Lotufo ; Ronaldo Batista dos Santos ; Silvana de Barros
• Associated scholarship(s): 22/04265-8 - Gut microbiome-derived exosomal microRNAs as potential biomarkers of Obstructive Sleep Apnea and cardiometabolic outcomes, BP.PD; 23/18466-8 - Impact of Obstructive Sleep Apnea Treatment on Blood Pressure Control in Chronic Kidney Disease: A Randomized Study, BP.TT; 23/07932-8 - Impact of Obstructive Sleep Apnea Treatment on Blood Pressure Control in Chronic Kidney Disease: A Randomized Trial, BP.IC; 23/05530-0 - Sleep Disturbances and Incidence of Hypertension: The ELSA-Brasil Cohort., BP.TT; 23/03725-8 - Sleep Disturbances and Incidence of Hypertension: ELSA-Brasil Epidemiological Study, BP.TT

Abstract

Sleep Disorders are increasingly common clinical conditions in our Society. Among these, we highlighted two of them: Obstructive Sleep Apnea (OSA) and short sleep duration (SSD). Previous studies suggested a positive association of sleep disorders with several cardiovascular diseases, including hypertension (HTN). Despite the advances in the area, several important issues remain poorly explored: 1) in isolation, both OSA and SSD are associated with HTN. However, studies that evaluated OSA did not consider the presence of CDS and vice versa. In addition, most of the studies evaluated sleep duration subjectively; 2) the role of OSA in target organ damage (TOD) in HTN is unclear; 3) the prognostic impact of OSA on resistant hypertension has not been studied; 4) the interaction of OSA with other causes of secondary HTN was little explored; 5) according to a recent statement from the American Heart Association, the effects of CPAP on blood pressure (BP) is still not well established, including in hypertensive patients with comorbidities, such as patients with chronic kidney disease; 6) the effect of CPAP on BP reduction is variable and the development of biomarkers predicting BP response and increased cardiovascular risk is highly desirable. Using a multidisciplinary and international collaboration approach, this Thematic Project aims to answer questions with clear clinical relevance on the impact of sleep disorders on HTN and TOD, the effect of OSA treatment on BP and TOD, the evaluation of potential mechanisms involved and the potential creation of biomarkers that predict risk and response to OSA treatment. (AU)

Scientific publications

(22)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

GIATTI, SORAYA; DRAGER, LUCIANO F.; INVESTIGATORS, ELSA-BRASIL. Reply: Salt, Diuretics, and Obstructive Sleep Apnea. ANNALS OF THE AMERICAN THORACIC SOCIETY, v. 18, n. 12, p. 2103-2104, DEC 2021. (12/02953-2, 19/23496-8)

SZLEJF, C.; SUEMOTO, C. K.; DRAGER, L. F.; GRIEP, R. H.; FONSECA, M. J. M.; DINIZ, M. F. H. S.; LOTUFO, P. A.; BENSEAOR, I. M.. Association of sleep disturbances with sarcopenia and its defining components: the ELSA-Brasil study. Brazilian Journal of Medical and Biological Research, v. 54, n. 12, 2021. (19/23496-8)

GIATTI, SORAYA; SANTOS, RONALDO B.; AIELO, ALINE N.; SILVA, WAGNER A.; PARISE, BARBARA K.; SOUZA, SILVANA P.; PIO-ABREU, ANDREA; BORTOLOTTO, LUIZ A.; LOTUFO, PAULO A.; BENSENOR, ISABELA M.; et al. Association of Sodium with Obstructive Sleep Apnea The ELSA-Brasil Study. ANNALS OF THE AMERICAN THORACIC SOCIETY, v. 18, n. 3, p. 502-510, MAR 2021. (12/02953-2, 19/23496-8)

SANTOS, RONALDO B.; GIATTI, SORAYA; AIELO, ALINE N.; SILVA, WAGNER A.; PARISE, BARBARA K.; CUNHA, LORENNA F.; SOUZA, SILVANA P.; ALENCAR, AIRLANE P.; LOTUFO, PAULO A.; BENSENOR, ISABELA M.; et al. Self-reported versus actigraphy-assessed sleep duration in the ELSA-Brasil study: analysis of the short/long sleep duration reclassification. Sleep and Breathing, NOV 2021. (12/02953-2, 19/23496-8)

GIAMPA, S.; PIO-ABREU, A.; CABRINI, M.; BORTOLOTTO, L.; LORENZI-FILHO, G.; ALMEIDA, M.; DRAGER, L.. HIGH FREQUENCY OF OBSTRUCTIVE SLEEP APNEA IN CONSECUTIVE PATIENTS WITH PRIMARY HYPERALDOSTERONISM: PRELIMINARY RESULTS. Sleep Medicine, v. 115, p. 2-pg., 2024-02-01. (19/23496-8)

PIO-ABREU, ANDREA; TRANI-FERREIRA, FERNANDA; SILVA, GIOVANIO, V; BORTOLOTTO, LUIZ A.; DRAGER, LUCIANO F.. Directly observed therapy for resistant/refractory hypertension diagnosis and blood pressure control. HEART, v. N/A, p. 5-pg., 2022-04-20. (19/23496-8)

CABRINI, MAYARA L.; MACEDO, THIAGO A.; CASTRO, EMERSON; DE BARROS, SILVANA; AZAM, INDIRA; PIO-ABREU, ANDREA; SILVA, GIOVANIO V.; LORENZI-FILHO, GERALDO; BORTOLOTTO, LUIZ A.; DRAGER, LUCIANO F.. Obstructive sleep apnea and hypertension-mediated organ damage in nonresistant and resistant hypertension. HYPERTENSION RESEARCH, v. 46, n. 8, p. 11-pg., 2023-06-01. (19/23496-8)

SUEMOTO, CLAUDIA K.; SANTOS, RONALDO B.; GIATTI, SORAYA; AIELO, ALINE N.; SILVA, WAGNER A.; PARISE, BARBARA K.; CUNHA, LORENNA F.; SOUZA, SILVANA P.; GRIEP, ROSANE H.; BRUNONI, ANDRE R.; et al. Association between objective sleep measures and cognitive performance: a cross-sectional analysis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) study. Journal of Sleep Research, v. N/A, p. 10-pg., 2022-05-29. (12/02953-2, 19/23496-8)

BALBI, GUSTAVO GUIMARAES MOREIRA; SIGNORELLI, FLAVIO; GANDARA, ANA PAULA; AZAM, INDIRA; DE BARROS, SILVANA; MARREIROS, DILSON; GENTA, PEDRO RODRIGUES; LOTUFO, PAULO ANDRADE; BENSENOR, ISABELA M.; DRAGER, LUCIANO F.; et al. Comorbid association of obstructive sleep apnea (OSA) and thrombotic primary antiphospholipid syndrome (tPAPS): A more severe phenotype?. Clinical Immunology, v. 256, p. 8-pg., 2023-09-27. (19/23496-8)

DE MIRANDA, ERIQUE J. F. PEIXOTO; PARISE, BARBARA K.; SANTOS, RONALDO B.; GIATTI, SORAYA; AIELO, ALINE N.; CUNHA, LORENNA F.; SILVA, WAGNER A.; SOUZA, SILVANA P.; LOTUFO, PAULO A.; BENSENOR, ISABELA M.; et al. Weekend sleep extension, social jetlag, and incidence of coronary calcium score: the ELSA-Brasil study. Sleep, v. N/A, p. 11-pg., 2025-03-29. (19/23496-8)

PARISE, BARBARA K.; SANTOS, RONALDO B.; MESAS, ARTHUR E.; SILVA, WAGNER A.; GIATTI, SORAYA; AIELO, ALINE N.; CUNHA, LORENNA F.; SOUZA, SILVANA P.; BORTOLOTTO, LUIZ A.; GRIEP, ROSANE H.; et al. Sleep irregularity and the association with hypertension and blood pressure levels: the ELSA-Brasil study. Journal of Hypertension, v. 41, n. 4, p. 8-pg., 2023-04-01. (12/02953-2, 19/23496-8)

SOUZA, SILVANA P.; SANTOS, RONALDO B.; SANTOS, ITAMAR S.; PARISE, BARBARA K.; GIATTI, SORAYA; AIELO, ALINE N.; CUNHA, LORENNA F.; SILVA, WAGNER A.; BORTOLOTTO, LUIZ A.; LORENZI-FILHO, GERALDO; et al. Obstructive Sleep Apnea, Sleep Duration, and Associated Mediators With Carotid Intima-Media Thickness The ELSA-Brasil Study. ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, v. 41, n. 4, p. 1549-1557, APR 2021. (19/23496-8)

COHEN, RICARDO V.; DRAGER, LUCIANO F.; PETRY, TARISSA B. Z.; SANTOS, RAUL D.. Metabolic health in Brazil: trends and challenges. LANCET DIABETES & ENDOCRINOLOGY, v. 8, n. 12, p. 2-pg., 2020-12-01. (19/23496-8)

DE MIRANDA, ERIQUE JOSE FARIAS PEIXOTO; MAZZOTTI, DIEGO R.; SANTOS, RONALDO B.; SOUZA, SILVANA P.; PARISE, BARBARA K.; GIATTI, SORAYA; AIELO, ALINE N.; CUNHA, LORENNA F.; SILVA, WAGNER A.; BORTOLOTTO, LUIZ A.; et al. Incident Coronary Calcium Score in Patients With OSA With and Without Excessive Sleepiness Brazilian Longitudinal Study of Adult Health. CHEST, v. 165, n. 1, p. 11-pg., 2024-01-08. (19/23496-8)

GIRARDI, ADRIANA C. C.; POLIDORO, JULIANO Z.; CASTRO, PAULO C.; PIO-ABREU, ANDREA; NORONHA, IRENE L.; DRAGER, LUCIANO F.. Mechanisms of heart failure and chronic kidney disease protection by SGLT2 inhibitors in nondiabetic conditions. AMERICAN JOURNAL OF PHYSIOLOGY-CELL PHYSIOLOGY, v. 327, n. 3, p. 20-pg., 2024-09-17. (21/14534-3, 19/23496-8)

GIAMPA, SARA Q. C.; VIANA, LUCIANA G.; CARDOZO, KARINA H. M.; MACEDO, THIAGO A.; FURLAN, SOFIA F.; FREITAS, LUNARA S.; BORTOLOTTO, LUIZ A.; LORENZI-FILHO, GERALDO; DRAGER, LUCIANO F.. Does Obstructive Sleep Apnea Treatment Influence Lipoprotein (a) Concentrations? Data from the TREATOSA-MS Clinical Trial. ANNALS OF THE AMERICAN THORACIC SOCIETY, v. 20, n. 12, p. 3-pg., 2023-12-01. (19/23496-8, 12/02953-2)

GIAMPA, SARA Q. C.; FURLAN, SOFIA F.; FREITAS, LUNARA S.; MACEDO, THIAGO A.; LEBKUCHEN, ADRIANA; CARDOZO, KARINA H. M.; CARVALHO, VALDEMIR M.; MARTINS, FRANCO C.; AZAM, INDIRA F. B.; COSTA-HONG, VALERIA; et al. Effects of CPAP on Metabolic Syndrome in Patients With OSA A Randomized Trial. CHEST, v. 161, n. 5, p. 12-pg., 2022-05-05. (12/02953-2, 19/23496-8)

MACEDO, THIAGO ANDRADE; GIAMPA, SARA Q. C.; FURLAN, SOFIA F.; FREITAS, LUNARA S.; LEBKUCHEN, ADRIANA; CARDOZO, KARINA H. M.; CARVALHO, VALDEMIR M.; MARTINS, FRANCO C.; MENDONCA, TIAGO; BORTOLOTTO, LUIZ A.; et al. Effect of continuous positive airway pressure on atrial remodeling and diastolic dysfunction of patients with obstructive sleep apnea and metabolic syndrome: a randomized study. OBESITY, v. 31, n. 4, p. 11-pg., 2023-02-28. (19/23496-8)

MAZZOTTI, DIEGO R.; DRAGER, LUCIANO F.. Opportunities for Cardiovascular Benefits in Treating Obstructive Sleep Apnea in the Secondary Prevention Scenario. American Journal of Respiratory and Critical Care Medicine, v. 202, n. 12, p. 4-pg., 2020-12-15. (19/23496-8)

FURLAN, SOFIA F.; SINKUNAS, VIKTOR; DAMIANI, LUCAS P.; SANTOS, RONALDO B.; PERES, MATHEUS; LEMOS, PEDRO A.; LEE, CHI-HANG; LORENZI-FILHO, GERALDO; DRAGER, LUCIANO F.. Obstructive sleep apnea, sleep duration and chronic kidney disease in patients with coronary artery disease. Sleep Medicine, v. 84, p. 268-274, AUG 2021. (19/23496-8, 12/02953-2)

CUNHA, LORENNA F.; SANTOS, RONALDO B.; GIATTI, SORAYA; PARISE, BARBARA K.; AIELO, ALINE N.; SILVA, WAGNER A.; SOUZA, SILVANA P.; BORTOLOTTO, LUIZ A.; LOTUFO, PAULO A.; BENSENOR, ISABELA M.; et al. Gender Modulated the Association of Sleep Apnea and Sleep Duration with Arterial Stiffness: The ELSA-Brasil Study. ANGIOLOGY, v. N/A, p. 9-pg., 2023-09-09. (19/23496-8)

GIAMPA, SARA Q. C.; LORENZI-FILHO, GERALDO; DRAGER, LUCIANO F.. Obstructive sleep apnea and metabolic syndrome. OBESITY, v. 31, n. 4, p. 12-pg., 2023-03-02. (19/23496-8)