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Influence of the severity of obstructive sleep apnea on nocturnal heart rate indices and its association with hypertension [Anatol J Cardiol]
Anatol J Cardiol. 2011; 11(6): 509-514 | DOI: 10.5152/akd.2011.135  

Influence of the severity of obstructive sleep apnea on nocturnal heart rate indices and its association with hypertension

Özcan Özeke1, Mutlu Güngör2, Serap Bilen Hızel3, Dilek Aydın3, Özcan Ertürk3, Mehmet Kutlu Çelenk2, Hazım Dinçer2, Gürler İliçin2, Fuat Özgen3, Can Özer2
1Department of Cardiology, Diyarbakır Military Hospital Diyarbakır
2Clinic of Cardiology, Bayındır Hospital, Ankara-Turkey
3Clinic of Sleep Disorder Center, Bayındır Hospital, Ankara-Turkey

Objective: Both heart rate (HR) and blood pressure parameters provide important information on the pathophysiology of the cardiovascular regulatory mechanisms, and are mainly affected by the autonomic nervous system. We sought to clarify whether the severity of obstructive sleep apnea (OSA) affects nocturnal HRs and whether there is a relationship between nocturnal HRs and the presence of hypertension. Methods: We retrospectively reviewed medical records of all patients who performed nocturnal polysomnography with monitoring of HRs, and examined whether there is a relationship among the nocturnal HRs, the severity of OSA and the presence of hypertension. Results: A total of 540 patients were included in the study. Nocturnal mean and maximal HRs were significantly higher in severe OSA group than in moderate (p=0.002 and p>0.05 in females; p<0.049 and p=0.044, in males, respectively) and mild OSA groups (p<0.001 and p=0.003, respectively in females, p<0.001 and p=0.004, respectively in males); and there was a positive correlation between the nocturnal mean HR and apnea-hypopnea index (Pearson’s p=0.504, p<0.001 in female group; Pearson’s p=0.254, p<0.001 in male group) and again the nocturnal mean HR and the presence of HT (Spearman’s p=0.090, p=0.394 in female group; Spearman’s p=0.272, p<0.001 in male group) in both gender groups. Conclusion: We found that nocturnal mean and maximal HRs to be associated with severity of OSA and the presence of hypertension. We speculated that increased nocturnal mean and maximal HRs caused by sympathetic nervous system activation in OSA might be one of the mechanisms in explaining the hypertension and OSA association.

Keywords: Nocturnal heart rate, sleep apnea, hypertension, sympathetic nervous system activation


Özcan Özeke, Mutlu Güngör, Serap Bilen Hızel, Dilek Aydın, Özcan Ertürk, Mehmet Kutlu Çelenk, Hazım Dinçer, Gürler İliçin, Fuat Özgen, Can Özer. Influence of the severity of obstructive sleep apnea on nocturnal heart rate indices and its association with hypertension. Anatol J Cardiol. 2011; 11(6): 509-514


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