INTER-ARM BLOOD PRESSURE DIFFERENCE IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA

Abstract

Objective: Obstructive sleep apnea (OSA) is an independent risk for cardiovascular disease. On the other hand, inter-arm systolic blood pressure difference (IAD) is noted as a marker for future cardiovascular events. However, underlying mechanisms of IAD has not been fully clarified. The present study was conducted to examine whether OSA is associated with IAD. Design and method: In 2645 consecutive patients aged over 30 {age: 56 ± 13 years old, mean apnea-hypopnea index (AHI): 39 ± 23 /h}, who visited sleep clinic to perform polysomnography in 2005–2017, blood pressure in both arms were measured simultaneously by oscillometric methods. The IAD was defined as absolute value of the systolic blood pressure difference in both arms. Results: In all included patients, patients with IAD over 10 mmHg were noted in 3.7%. When patients were divided into two groups: severe OSA (AHI over 30) group and mild to moderate OSA (AHI < 30) group, the prevalence rate of IAD over 10 mmHg were higher in severe OSA group than those in mild to moderate group (4.6% vs 2.8%, P < 0.05)(Figure). Multiple linear regression analysis demonstrated that AHI was an independent (P < 0.05) determinant of IAD, even after the adjustments of age, gender, body mass index, hypertension, and another variables. Conclusions: OSA may be a risk for IAD. The plausible explanation is that pathophysiological abnormalities related with OSA, such as the negative intrathoracic pressure, may affect IAD.