MicroRNA Profile of Cardiovascular Risk in Patients with Obstructive Sleep Apnea

Respiration ◽  
2020 ◽  
pp. 1-7
Author(s):  
Fernando Santamaria-Martos ◽  
Iván Benítez ◽  
Lucía Pinilla ◽  
Francisco Ortega ◽  
Andrea Zapater ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Cardiovascular Risk ◽  
Sleep Apnea ◽  
Risk Score ◽  
Common Disease ◽  
Cvd Risk ◽  
Cardiovascular Risk Score ◽  
Obstructive Sleep ◽  
The Impact

<b><i>Background:</i></b> Obstructive sleep apnea (OSA) is a common disease caused by repeated episodes of collapse of the upper airway during sleep and is associated with the development of cardiovascular disease (CVD). However, there is high heterogeneity in the impact of OSA on patients. Until now, the profile of OSA patients at risk of developing CVD has not been defined, including the measurable variables that could be used to predict the CVD risk of a patient with OSA. <b><i>Objective:</i></b> The aim of this study was to identify the microRNA (mi­RNA) profile associated with CVD in patients with OSA. <b><i>Method:</i></b> This is an observational, cross-sectional study that included 132 male patients. Three groups were defined as OSA patients, OSA patients with hypertension, and OSA patients who developed a major cardiovascular event. Polysomnography and ambulatory blood pressure measurements were performed. The expression profiling of 188 miRNAs in plasma was performed in 21 subjects (matched by BMI and age) by the TaqMan low density array (TLDA). miRNAs differentially expressed in the different subgroups of patients and miRNAs that correlated with the cardiovascular risk SCORE were selected for validation by RT-qPCR in the 111 remaining patients. <b><i>Results:</i></b> From the TLDA analysis, 7 miRNAs were selected for validation. Differential expression was not confirmed in any of the miRNAs. miR-143 was associated with nocturnal systolic blood pressure. miR-107 correlated with 24-h blood pressure parameters and with nocturnal hypertension. miR-486 was associated with the cardiovascular risk SCORE. <b><i>Conclusions:</i></b> The circulating profile of miRNAs does not seem to be different in any of the subgroups of patients with OSA and different cardiovascular risk factors. Nevertheless, miR-107 and miR-143 are associated with specific blood pressure parameters in patients with OSA and miR-486 is associated with the cardiovascular risk SCORE.

scholarly journals Low Physical Activity Is a Determinant for Elevated Blood Pressure in High Cardiovascular Risk Obstructive Sleep Apnea

2013 ◽  
Vol 59 (8) ◽  
pp. 1218-1227 ◽  
Author(s):  
M. Mendelson ◽  
R. Tamisier ◽  
D. Laplaud ◽  
S. Dias-Domingos ◽  
J.-P. Baguet ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Cardiovascular Risk ◽  
Sleep Apnea ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
High Cardiovascular Risk ◽  
Obstructive Sleep

scholarly journals Effect of Maternal Obstructive Sleep Apnea-Hypopnea on 24-Hour Blood Pressure, Nocturnal Blood Pressure Dipping and Arterial Stiffness in Hypertensive Disorders of Pregnancy

2021 ◽  
Vol 12 ◽  
Author(s):  
Pattaraporn Panyarath ◽  
Noa Goldscher ◽  
Sushmita Pamidi ◽  
Stella S. Daskalopoulou ◽  
Robert Gagnon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Arterial Stiffness ◽  
Hypertensive Disorders Of Pregnancy ◽  
Adjusted Analysis ◽  
Nocturnal Blood Pressure ◽  
Hypertensive Disorders ◽  
Obstructive Sleep ◽  
The Impact

Rationale: Maternal obstructive sleep apnea-hypopnea (OSAH) is associated with hypertensive disorders of pregnancy (HDP). Attenuation of the normal nocturnal blood pressure (BP) decline (non-dipping) is associated with adverse pregnancy outcomes. OSAH is associated with nocturnal non-dipping in the general population, but this has not been studied in pregnancy. We therefore analyzed baseline data from an ongoing RCT (NCT03309826) assessing the impact of OSAH treatment on HDP outcomes, to evaluate the relationship of OSAH to 24-h BP profile, in particular nocturnal BP dipping, and measures of arterial stiffness.Methods: Women with a singleton pregnancy and HDP underwent level II polysomnography. Patients with OSAH (apnea-hypopnea index (AHI) ≥ 5 events/h) then underwent 24-h ambulatory BP monitoring and arterial stiffness measurements (applanation tonometry, SphygmoCor). Positive dipping was defined as nocturnal systolic blood pressure (SBP) dip ≥ 10%. The relationships between measures of OSAH severity, measures of BP and arterial stiffness were evaluated using linear regression analyses.Results: We studied 51 HDP participants (36.5 ± 4.9 years, BMI 36.9 ± 8.6 kg/m2) with OSAH with mean AHI 27.7 ± 26.4 events/h at 25.0 ± 4.9 weeks’ gestation. We found no significant relationships between AHI or other OSA severity measures and mean 24-h BP values, although BP was generally well-controlled. Most women were SBP non-dippers (78.4%). AHI showed a significant inverse correlation with % SBP dipping following adjustment for age, BMI, parity, gestational age, and BP medications (β = −0.11, p = 0.02). Significant inverse correlations were also observed between AHI and DBP (β = −0.16, p = 0.01) and MAP (β = −0.13, p = 0.02) % dipping. Oxygen desaturation index and sleep time below SaO2 90% were also inversely correlated with % dipping. Moreover, a significant positive correlation was observed between carotid-femoral pulse wave velocity (cfPWV) and REM AHI (β = 0.02, p = 0.04) in unadjusted but not adjusted analysis.Conclusion: Blood pressure non-dipping was observed in a majority of women with HDP and OSAH. There were significant inverse relationships between OSAH severity measures and nocturnal % dipping. Increased arterial stiffness was associated with increasing severity of OSAH during REM sleep in unadjusted although not adjusted analysis. These findings suggest that OSAH may represent a therapeutic target to improve BP profile and vascular risk in HDP.

Abstract 2462: Obstructive Sleep Apnea Treatment Improves the Blood Pressure Behavior in Normotensive Patients: A Randomized Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Luciano F Drager ◽  
Patrícia M Diniz ◽  
Luzia Diegues-Silva ◽  
Roberta B Couto ◽  
Rodrigo P Pedrosa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Randomized Study ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
The Impact ◽  
Current Guidelines ◽  
Concomitant Hypertension

Introduction: Obstructive sleep apnea (OSA) promotes significant alterations on blood pressure during sleep. In patients with concomitant hypertension, the treatment with continuous positive airway pressure (CPAP) promotes significant reductions on blood pressure. However, the impact of CPAP on 24 hour blood pressure in normotensive patients is poorly understood. Methods: We included 22 apparently healthy patients with severe OSA defined by polysomnography (apnea/hypopnea index (AHI) >30 events/hour). We excluded hypertension according current guidelines by office measurements. They were randomized to no treatment (control) or CPAP for 3 months. At baseline and at the end of the protocol, we performed 24 hour blood pressure (BP) monitoring evaluating daytime and nighttime BP as well as the morning surge (average of systolic BP during the 2 hours after awakening minus the average of systolic BP during the 1 hour that included the lowest nighttime BP) and highest systolic nighttime BP (mean of 3 BP measurements, centered on the highest nighttime reading). Results: After 3 months, patients randomized to CPAP (mean CPAP usage: 6 hours) presented a significant reduction on daytime (80.3±6.3 to 75.3±6.9 mmHg; P=0.02) and nighttime diastolic BP (67.8±9.5 to 61.4±7.5 mmHg; P=0.03). In addition, we observed a significant reduction on highest nighttime systolic BP (120.0±13.6 to 112.0±.9 mmHg; P=0.02) with a trend for a reduction on morning surge (22.3±9.2 to 17.3±.4 mmHg; P=0.08). No significant alterations occurred in the control group. Conclusion: Even in the absence of established hypertension, CPAP therapy improved the behavior of 24 hour BP in patients with severe OSA.

Abstract 19539: Obstructive Sleep Apnea Screening Resulting in Improved CVD Risk Score

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Mary Ann McLaughlin ◽  
Rupa L Iyengar ◽  
Heather N Beebe ◽  
Bianca Jamar ◽  
Mark Woodward ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Large Population ◽  
High Sensitivity ◽  
Anthropometric Measurements ◽  
Berlin Questionnaire ◽  
Cvd Risk ◽  
Obstructive Sleep ◽  
The Impact

Introduction: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder with a prevalence of 15 - 20% in the general population. OSA is related to numerous disorders and increases risk of cardiovascular disease (CVD) and CV events including myocardial infarction and cerebrovascular accidents. Behavioral modification is a quintessential component of treatment for OSA. Hypothesis: We sought to evaluate and quantify the impact of Law Enforcement Cardiac Screening (LECS) program on change in OSA risk. Methods: Patients seen in World Trade Center (WTC) LECS from 2008 - 2010 were reevaluated in WTC CHEST from 2012 - 2014. We analyzed 959 patients’ anthropometric measurements and CV risk factors against status of high risk for OSA (OSA+) defined as never met, only met criteria in LECS, only met criteria in CHEST and met criteria in both LECS and CHEST. OSA+ was defined as 2 or more positive categories on the Berlin Questionnaire (BQ). Independent t-test, ANOVA, and multivariate regression analyses were used to assess the impact of WTC LECS on OSA+ as it relates to body mass index (BMI), waist circumference, and high sensitivity CRP (hsCRP) Results: We found that those who only met high risk for OSA criteria in 2008 - 2010 (LECS only) had a significant decrease in BMI when reevaluated in 2012 - 2014 (CHEST) (41.5 kg/m2 vs. 38.4 kg/m2 respectively; p < 0.001). Patients only diagnosed in 2008 - 2010 had a significant decrease in hsCRP compared to those diagnosed in 2012 - 2014 (-1.44 vs -0.37 respectively, p = 0.040). Conclusions: Using the BQ as screening tool for OSA in a large population of asymptomatic middle aged participants allowed identification approximately 40% of the initial screening population to be at OSA+. Identifying these participants allowed us to counsel and advise patients of pertinent behavioral modifications known to improve risks for OSA. These efforts resulted in significant reduction in anthropometric measurements and improved CVD 10 year risk.

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