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Original Research: Sleep Disorders |

OSA Is Common and Independently Associated With Hypertension and Increased Arterial Stiffness in Consecutive Perimenopausal WomenOSA Increases Arterial Stiffness in Perimenopause

Rodrigo P. Pedrosa, MD, PhD; Isly M. L. Barros, MD; Luciano F. Drager, MD, PhD; Marcio S. Bittencourt, MD, MPH; Ana Kelley L. Medeiros, RN; Liana L. Carvalho, RN; Thais C. Lustosa, RpT; Martinha M. B. Carvalho, RpT; Moacir N. L. Ferreira, MD, PhD; Geraldo Lorenzi-Filho, MD, PhD; Laura O. B. F. Costa, MD, PhD
Author and Funding Information

From the Sleep and Heart Laboratory (Drs Pedrosa, Barros, and Ferreira and Mss Medeiros, L. L. Carvalho, Lustosa, and M. M. B. Carvalho), Pronto Socorro Cardiológico de Pernambuco (PROCAPE) da Universidade de Pernambuco, and PROCAPE da Universidade de Pernambuco (Drs Barros and Costa), Pernambuco; Sleep Laboratory (Drs Drager and Lorenzi-Filho), Pulmonary Division, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo; and University Hospital (Dr Bittencourt), University of São Paulo, São Paulo, Brazil.

CORRESPONDENCE TO: Rodrigo P. Pedrosa, MD, PhD, Sleep and Heart Laboratory, PROCAPE da Universidade de Pernambuco, Rua dos Palmares, SN, Recife, Pernambuco, Brazil; e-mail: rppedrosa@terra.com.br


This study has been presented in poster form at the American Thoracic Society International Conference, May 17-22, 2013, Philadelphia, PA.

FUNDING/SUPPORT: This work was supported by the Fundação de Amparo à Ciência e Tecnologia do Estado de Pernambuco.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(1):66-72. doi:10.1378/chest.14-0097
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BACKGROUND:  Perimenopause is associated with increased cardiovascular risk. OSA is an emerging risk factor for cardiovascular disease, particularly among men, but the independent contribution of OSA to cardiovascular risk in climacteric women is not clear.

METHODS:  We evaluated 277 consecutive women (age, 56 [52-61] years; BMI, 28 [25-32] kg/m2) without manifest cardiovascular disease (heart failure, coronary disease, or stroke). All women underwent 24-h ambulatory BP monitoring, arterial stiffness evaluation (pulse wave velocity), and portable sleep study.

RESULTS:  OSA (apnea-hypopnea index ≥ 5 events/h) and moderate to severe OSA (apnea-hypopnea index ≥ 15 events/h) were diagnosed in 111 (40.1%) and 31 (11.1%) women, respectively. None of the participants had received a previous diagnosis of OSA. Women with moderate to severe OSA vs those without OSA had a higher prevalence of hypertension, were prescribed more medications for hypertension, had higher awake BP (systolic, 133 [125-142] vs 126 [119-134] mm Hg [P < .01]; diastolic, 82 [78-88] vs 79 [74-85] mm Hg [P = .07]), higher nocturnal BP (systolic, 125 [118-135] vs 115 [109-124] mm Hg [P < .01]; diastolic, 73 [69-79] vs 69 [62-75] mm Hg [P < .01]), and more arterial stiffness (pulse wave velocity, 11.5 [10.1-12.3] m/s vs 9.5 [8.6-10.8] m/s, P < .001). Oxygen desaturation index during the night was independently associated with 24-h arterial BP and arterial stiffness (per five-unit increase in oxygen desaturation index, β = 1.30 [95% CI, 0.02-2.54; P = .04] vs 0.22 [95% CI, 0.03-0.40; P = .02] in women with vs without OSA, respectively).

CONCLUSIONS:  OSA is common, underdiagnosed, and independently associated with high BP and increased arterial stiffness in perimenopausal women.

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