HYPERTENSIVE IMMIGRANTS ARE CHARACTERIZED BY LOWER PREVELANCE OF OBSTRUCTIVE SLEEP APNEA COMPARED TO NATIVE HYPERTENSIVES: A DIFFERENCE BEYOND ARTERIAL STIFFNESS: PP.32.281

Abstract

Objective: Obstructive sleep apnea syndrome (OSAS) and essential hypertension (EH) are closely associated, while increased arterial stiffness is a marker of diffuse vascular disease. In light of the mass immigration of Eastern European residents, we sought to investigate the prevalence of OSAS along with the assessment of the arterial stiffness within this high risk population Design and Method: We studied 67 Eastern European immigrants with newly diagnosed untreated stage I-II EH (aged = 51.5 ± 15 years, 35 = male, office blood pressure (BP) = 158/92 mm Hg), who immigrated to Greece within the previous two years and 61 untreated hypertensive native inhabitants, matched for age, gender, office BP and smoking status. All participants underwent polysomnography (apnea/hypopnea index >5) and arterial stiffness evaluation on the basis of carotid to femoral pulse wave velocity (c-f PWV) by means of a computerized method (Complior SP), while metabolic profile and anthropometric data were assessed as well. Results: Hypertensive immigrants compared to native ones demonstrated decreased prevalence of OSAS (9.1% vs 12%,p = 0.014) and decreased levels of body mass index (29.3 ± 4 vs 32.2 ± 4 kg/m2,p < 0.05). There was evidence that c-f PWV was elevated in the group of immigrants (8.4 ± 0.3 vs 7.2 ± 0.5 m/sec,p < 0.05). Immigrants also exhibited decreased waist circumference (94 ± 3 vs101 ± 2 cm,p < 0.05). The two groups did not differ with regard to serum glucose and cholesterol levels (99 ± 9 vs102 ± 8 mg/dl and 226 ± 40 vs 228 ± 35 mg/dl, respectively,p = NS in both cases). Analysis of covariance revealed that the prevalence of OSAS and c-f PWV values remained statistically different between the two groups after adjustment for confounding factors (p < 0.05). Conclusions: Hypertensive immigrants demonstrate lower prevalence of OSAS but they seem to have stiffer aorta compared to native hypertensives. Efforts should be directed at this vulnerable population focusing on putative mechanisms for this unfavourable and apparently paradox BP phenotype.