Undiagnosed sleep‐disordered breathing among male nondippers with essential hypertension
作者:
Francesco Portaluppi,
Federica Provini,
Pietro Cortelli,
Giuseppe Plazzi,
Nino Bertozzi,
Roberto Manfredini,
Carmelo Fersini,
Elio Lugaresi,
期刊:
Journal of Hypertension
(OVID Available online 1997)
卷期:
Volume 15,
issue 11
页码: 1227-1233
ISSN:0263-6352
年代: 1997
出版商: OVID
关键词: blood pressure;circadian rhythm;hypertension;snoring;sleep apnea;polysomnography
数据来源: OVID
摘要:
ObjectiveA blunting of the nocturnal fall in arterial blood pressure is found in a minority of patients (nondippers) with essential hypertension. We tested whether sleep-disordered breathing (snoring and apnea or hypopnea) might explain such a finding for male patients, among whom its prevalence is much higher.Setting and patientsWe studied 100 new cases of hypertension in men, observed consecutively by a local group of general practitioners and diagnosed essential hypertensives in a referral clinic. By using 24 h ambulatory blood pressure monitoring with a SpaceLabs 90207 device, 15 patients were classified initially nondippers (daytime ambulatory blood pressure ≥ 136/87 mmHg; night-time decrease by < 10% of the daytime mean), but only 11 were confirmed to be nondippers by continuous blood pressure monitoring with a Finapres device. Ten dippers matched by age, body mass index and mean 24 h blood pressure were used as controls.Main outcomemeasures Parameters of nocturnal polysomnography.ResultsDuring polysomnography, the nondippers exhibited a blunting of the sleep-related fall in blood pressure and an increased variability in blood pressure associated with sleep-disordered breathing (heavy snoring for all, with an apnea or hypopnea index > 10 in 10 cases). Six of the control patients breathed normally and four snored nonapneically. There was a normal fall in nocturnal blood pressure in all 10 cases.ConclusionsThe nondipper condition appears to be associated with undiagnosed apneic snoring for an unselected population of previously untreated male subjects with a diagnosis of essential hypertension. Ambulatory blood pressure monitoring of such patients is of limited diagnostic value.
点击下载:
PDF
(289KB)
返 回