Moderate to severe obstructive sleep apnea is independently associated with inter-arm systolic blood pressure difference: Tokyo Sleep Heart Study

Abstract

Objective: Obstructive sleep apnea (OSA) is recognized as an independent risk factor for cardiovascular disease. On the other hand, inter-arm systolic blood pressure difference (IAD), inter-ankle systolic blood pressure difference (IAND), and ankle-brachial index (ABI) are all known predictors of cardiovascular events. The aim of the present study was to investigate the association between OSA and four-limb blood pressure differences.Methods: We conducted this cross-sectional study in a large sleep cohort from Tokyo Sleep Heart Study. In 2643 consecutive patients who visited our sleep clinic for polysomnography between 2005 and 2017, all the patients underwent blood pressure measurement simultaneously in all the four limbs by oscillometric methods. Results:The prevalence rate of IAD !10 mmHg was significantly higher in the moderate OSA (15 apneahypopnea index [AHI] < 30) group (4.2%) and severe OSA (AHI ! 30) group (4.6%) than that in the no/mild (AHI < 15) OSA group (1.4%). Multivariate logistic regression analysis also identified moderate to severe OSA as being significantly associated with IAD !10 mmHg, even after adjustments for confounding variables (moderate OSA: odds ratio [OR], 4.869; 95% confidence interval [CI], 1.080-21.956; P ¼ 0.039; severe OSA: OR, 5.301; 95% CI, 1.226-22.924; P ¼ 0.026). However, there were no significant associations of the OSA severity with IAND !15 mmHg or ABI <0.9.Conclusions: Moderate to severe OSA was independently associated with the IAD, not but with the IAND or ABI.

Nutritional Status and Sleep Quality Are Associated with Atrial Fibrillation in Patients with Obstructive Sleep Apnea: Results from Tokyo Sleep Heart Study

“…This is the first study to demonstrate that nutritional status and sleep quality were associated with the presence of AF in patients with OSA from a large Japanese sleep cohort (Tokyo Sleep Heart Study) [ 24 ]. In this study, all OSA patients were accurately diagnosed by performing a full PSG, and all OSA patients also underwent electrocardiography and echocardiography to accurately assess AF and cardiac functions.…”

“…The Tokyo Sleep Heart Study is an ongoing large-scale cohort study conducted at the Tokyo Medical University Sleep Laboratory, which began enrolling Japanese patients in November 2004. This study aims to investigate the influence of sleep disorder breathing on cardiovascular disease [ 24 ].…”

“…In this study, we aimed to determine the prevalence of AF and discover the clinical factors predictive of AF in patients with OSA from a large Japanese sleep cohort (Tokyo Sleep Heart Study) [ 24 ]. In particular, we examined the associations between nutritional status, sleep quality, and the presence of AF in patients with OSA.…”