SLEEP BLOOD PRESSURE AND SLEEP BLOOD PRESSURE SURGE IN PATIENTS WITH SLEEP DISORDERED BREATHING AND HEART FAILURE

Abstract

Objective: In patients with sleep disordered breathing (SDB), sleep apnea episode causes an acute transient blood pressure (BP) elevation (ie, BP surge). The SOMNO touch, a new full polysomnography device which can measure beat-to-beat BP by pulse transit time (PTT), can reveal whole of sleep BP and sleep BP surge non-invasively. The aim of this study was to evaluate whether sleep BP and sleep BP surge in HF patients were higher or not compared with those in non-HF patients. Design and method: We enrolled 24 patients with SDB. Heart failure patients were defined as patients with past history of congestive heart failure. Office BP was the average of three consecutive brachial BP (Oscillometric). Full polysomnography and pulse transit time sleep BP (beat-to-beat BP) were measured by SOMNO touch. Results: We analyzed 13 HF patients (age 72.2 ± 14.2, BMI 24.1 ± 5.3) and 11 non-HF patients (age 66.6 ± 9.9, BMI 25.8 ± 3.4). There was no significant difference in age and BMI between the two groups. Left ventricular ejection fraction (47.8 ± 13.5 vs. 64.3 ± 13.4, p = 0.007) was significantly lower, and NT-proBNP (2971.7 (1821.0 to 4848.4) vs. 697.9 (307.5 to 1584.1), p = 0.002) was significantly higher in the HF group compared with the non-HF group. Concerning SDB, there was no significant difference in obstructive apnea index (AI) (10.2 ± 7.9 vs. 10.4 ± 5.1, p = 0.956), central AI (5.5 ± 8.7 vs. 5.6 ± 6.0, p = 0,965), apnea hypopnea index (AHI) (22.5 ± 15.9 vs. 23.2 ± 11.0, p = 0.904), and the lowest oxygen saturation (84.5 ± 6.4 vs. 84.2 ± 4.0, p = 0.874) between the two groups. Office systolic BP (SBP) (111.0 ± 19.8 vs. 106.8 ± 13.6, p = 0.560) was similar. Concerning PTT BP, the highest sleep SBP (138.9 ± 10.2 vs. 132.5 ± 14.7, p = 0.217) and the largest increase in sleep SBP (20.6 ± 9.2 vs. 29.1 ± 15.6, p = 0.137) were similar, whereas mean sleep SBP (116.7 ± 10.0 vs. 105.3 ± 8.0, p = 0.006) and the lowest sleep SBP (104.3 ± 13.3 vs. 87.2 ± 13.7, p = 0.008) were significantly higher in the HF group compared with the non-HF group. Conclusions: The highest sleep SBP and the largest sleep BP surge were similar, whereas the mean sleep SBP and the minimum sleep SBP were significantly higher in the HF group compared with those in the non-HF group.