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OSA adds to stroke risk in hypertensives
19 November 2008
MedWire News: Patients with hypertension should be investigated for obstructive sleep apnea (OSA), say researchers who found the two conditions have additive effects on early markers of carotid atherosclerosis.
“These findings could be implicated in the rate of progression of carotid atherosclerosis in these patients, which could further contribute to increase the risk for stroke,” comments the team.
To determine the impact of OSA and hypertension on carotid atherosclerosis, Luciano Drager (University of São Paulo Medical School, Brazil) and co-workers selected study participants who were free of diabetes and did not smoke.
They report that 25 patients with OSA and 20 with hypertension had significantly elevated carotid intima-media thickness (IMT), at an average of 713 μm for both groups, compared with 597 μm in 22 controls. But it was further increased in 27 patients with both conditions, at 837 μm.
Carotid diameter was also larger in patients with OSA or hypertension than in controls, and was larger again in those with both conditions.
“OSA and hypertension presented a distinct pattern of vascular damage,” the researchers report in the journal Hypertension.
Carotid distensibility was significantly reduced in patients with hypertension and with hypertension plus OSA, relative to controls, but not in patients with OSA only.
On multivariate analysis, both hypertension and OSA were associated with carotid IMT. Only OSA was related to carotid diameter, but only age and hypertension were related to carotid distensibility.
“Although OSA seems to be more involved with structural damage of this elastic artery, the presence of hypertension could negatively influence both the structural and functional properties of this vessel,” say Drager et al.
The researchers stress that OSA is underdiagnosed in patients with hypertension, and that treatment of OSA can ameliorate its ill effects and reduce vascular risk.
“Our results reinforce the importance of OSA in patients with hypertension,” they conclude.
