Use of Ambulatory Blood Pressure Monitoring for the Screening of Obstructive Sleep Apnea

使用动态血压监测筛查阻塞性睡眠呼吸暂停

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作者:Gerard Torres, Manuel Sánchez-de-la-Torre, Montserrat Martínez-Alonso, Silvia Gómez, Oscar Sacristán, Jacint Cabau, Ferran Barbé

Abstract

Obstructive sleep apnea (OSA) is a frequent and underdiagnosed disease in hypertensive individuals who experience cardiovascular events. The aim of this study was to define the best model that combined the ambulatory blood pressure (BP) monitoring (ABPM), anthropometric, sociodemographic, and biological variables to identify moderate to severe OSA. A total of 105 ABPM-confirmed hypertensive patients were evaluated using their clinical histories, blood analyses, ABPM, and home respiratory polygraphic results. A multivariate logistic regression analysis was performed to identify the significant variables. The best model included sex, presence of obesity (body mass index ≥30 kg/m(2) and abdominal obesity), mean daytime BP, mean nocturnal heart rate, and minimal diastolic nighttime BP to achieve an area under the curve of 0.804. Based on this model, a validated scoring system was developed to identify the patients with an apnea-hypopnea index ≥15. Therefore, in untreated hypertensive patients who snored, ABPM variables might be used to identify patients at risk for OSA.

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