Elsanan Moataz Ali Hasan Ali, Soliman Mohammad Hassan, Meawad Bishoy Meawad Nicola, Kandeel Nader Talat, Elshora Ashraf, Shehata Islam Elsayed
Department of Cardiovascular Medicine, Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt.
Department of Cardiovascular Medicine, 15 May Hospital, Ministry of Health, 15 May city, Helwan, 14531, Egypt.
Sleep Breath. 2025 May 22;29(3):193. doi: 10.1007/s11325-025-03365-5.
A high prevalence of non-dipping diastolic blood pressure (DBP) patterns has been observed in Obstructive Sleep Apnea (OSA), suggesting that diminished circadian blood pressure variability may significantly contribute to hypertensive end-organ damage.
This study aimed to evaluate cardiovascular complications in non-dipper OSA patients using a combination of 24-hour Ambulatory Blood Pressure Monitoring (ABPM), Holter electrocardiography, and transthoracic echocardiography (TTE).
This cross-sectional study assessed 64 adult non-dipper OSA patients. The patients, with an average age of 46.5 years, underwent clinical assessments via sphygmomanometer, resting electrocardiogram (ECG), TTE, 24-hour ABPM, and 24-hour Holter ECG. The average age of the patients was 46.5 years, with 50% exhibiting grade 2 obesity. OSA severity was classified as follows: 42.2% moderate; 32.8% severe; and 25% mild. A positive correlation was identified between OSA severity and body mass index (BMI), diabetes, and hypertension. ABPM revealed masked hypertension in 45% of participants. TTE showed that severe OSA was linked to regional wall motion abnormalities, ischemic changes, and increased interventricular septal thickness. Elevated pulmonary artery systolic pressure is predominantly observed in patients with severe OSA. Holter monitoring detected intermittent atrial fibrillation in 15.6% and infrequent extrasystoles in 31.2%. The multivariate logistic regression analysis identified BMI, age, male gender, and the presence of hypertension and diabetes mellitus as significant risk factors for severe OSA. Higher BMI, age, male gender, and these comorbidities increased the likelihood of severe OSA, with odds ratios of 1.22, 1.03, 2.80, and 1.85, respectively.
The 24-hour ABPM is an effective tool for detecting masked hypertension in non-dipper OSA patients. Additionally, the severity is directly associated with an increased risk of cardiovascular disease (CVD). Regular cardiovascular assessments are recommended for patients with OSA to mitigate potential complications.
ZUIRB#9417/2042022 Registered 20 April 2022, email IRB_123@medicine.zu.edu.eg.
在阻塞性睡眠呼吸暂停（OSA）患者中观察到非勺型舒张压（DBP）模式的高患病率，这表明昼夜血压变异性降低可能是高血压终末器官损害的重要原因。
本研究旨在通过24小时动态血压监测（ABPM）、动态心电图和经胸超声心动图（TTE）评估非勺型OSA患者的心血管并发症。
这项横断面研究评估了64名成年非勺型OSA患者。这些患者平均年龄为46.5岁，通过血压计、静息心电图（ECG）、TTE、24小时ABPM和24小时动态心电图进行临床评估。患者的平均年龄为46.5岁，50%表现为2级肥胖。OSA严重程度分类如下：42.2%为中度；32.8%为重度；25%为轻度。OSA严重程度与体重指数（BMI）、糖尿病和高血压之间存在正相关。ABPM显示45%的参与者存在隐匿性高血压。TTE显示重度OSA与局部室壁运动异常、缺血性改变和室间隔厚度增加有关。重度OSA患者主要观察到肺动脉收缩压升高。动态心电图监测发现15.6%的患者出现间歇性房颤，31.2%的患者出现偶发性早搏。多因素逻辑回归分析确定BMI、年龄、男性性别以及高血压和糖尿病的存在是重度OSA的重要危险因素。较高的BMI、年龄、男性性别以及这些合并症增加了重度OSA的可能性，优势比分别为1.22、1.03、2.80和1.85。
24小时ABPM是检测非勺型OSA患者隐匿性高血压的有效工具。此外，严重程度与心血管疾病（CVD）风险增加直接相关。建议对OSA患者进行定期心血管评估，以减轻潜在并发症。
ZUIRB#9417/2042022 于2022年4月20日注册，电子邮件IRB_123@medicine.zu.edu.eg。
