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

Autor(es)

Garcia, Carlos E. V. ^[1] ; Drager, Luciano F. ^[2] ; Krieger, Eduardo M. ^[2] ; Negrao, Carlos E. ^{[3, 2]} ; Bortolotto, Luiz A. ^[2] ; Lorenzi-Filho, Geraldo ^[2] ; Ueno, Linda M. ^[4]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Fac Med, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Heart Inst InCor, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Sch Phys Educ & Sport, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Sch Arts Sci & Humanities, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: AMERICAN JOURNAL OF HYPERTENSION; v. 26, n. 5, p. 617-623, MAY 2013.
• Citações Web of Science: 8

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. (AU)

• Processo FAPESP: 10/18183-6 - Avaliação hemodinâmica dos microdespertares durante o sono em pacientes com hipertensão arterial
• Beneficiário: Carlos Eduardo Verzine Garcia
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica