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Nocturnal pulse wave attenuation is associated with office blood pressure in a population based cohort

Zou, Ding; Grote, Ludger; Radlinski, Jakub; Eder, Derek N.; Lindblad, Ulf LU and Hedner, Jan (2009) In Sleep Medicine 10(8). p.836-843
Abstract
Objective and Background: Pulse wave amplitude (PWA) derived from the digital vascular bed has been used in sleep studies. The nocturnal attenuation of PWA has been shown to reflect sympathetic activation during sleep. We assessed the relationship between nocturnal PWA attenuation and office blood pressure (BP). Methods: Eighty-one subjects (46 men; age 60 7 years: body mass index [BMI] 28.2 +/- 4.3 kg/m(2); apnea hypopnea index [AHI], 25.4 +/- 22.6 events/h; systolic BP 137 +/- 15 mmHg; diastolic BP 79 +/- 7 mmHg) recruited from a population based cohort underwent simultaneous ambulatory polysomnography (PSG) and peripheral arterial tonometry (PAT) recording. Episodic attenuations of PWA derived from the pulse waveform of the PAT signal... (More)
Objective and Background: Pulse wave amplitude (PWA) derived from the digital vascular bed has been used in sleep studies. The nocturnal attenuation of PWA has been shown to reflect sympathetic activation during sleep. We assessed the relationship between nocturnal PWA attenuation and office blood pressure (BP). Methods: Eighty-one subjects (46 men; age 60 7 years: body mass index [BMI] 28.2 +/- 4.3 kg/m(2); apnea hypopnea index [AHI], 25.4 +/- 22.6 events/h; systolic BP 137 +/- 15 mmHg; diastolic BP 79 +/- 7 mmHg) recruited from a population based cohort underwent simultaneous ambulatory polysomnography (PSG) and peripheral arterial tonometry (PAT) recording. Episodic attenuations of PWA derived from the pulse waveform of the PAT signal were identified and characterized. Generalized least squares regression models were used to identify the associations between median PWA attenuation (PWA.att), office BP and sleep-related disordered breathing. Results: We found that the association between PWA.att and office BP was independent of gender, age, BMI, anti hypertensive medication, number of attenuation episodes, AHI, oxygen desaturation >= 4% index (ODI4) and arousal index. Each 10% increase in PWA.att was associated with increases of 5.0 mmHg systolic BP (P = 0.02) and 3.0 mmHg diastolic BP (P = 0.005). We also found independent relationships between systolic/diastolic BP and BMI (P = 0.0006/0.001), AHI (P = 0.0310.1) and ODI4 (P = 0.03/0.03). Conclusions: The degree of PWA attenuation during the night is associated with office BP independent of sleep-disordered breathing. Continuous assessment of PWA during sleep may provide novel insights into cardiovascular physiology and morbidity. (C) 2008 Elsevier B.V. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
arterial tone, Peripheral, Body mass index, Autonomic activity, Office blood pressure, Sleep apnea, Pulse wave amplitude, Polysomnography
in
Sleep Medicine
volume
10
issue
8
pages
836 - 843
publisher
Elsevier
external identifiers
  • wos:000269995600006
  • scopus:68849088503
ISSN
1878-5506
DOI
10.1016/j.sleep.2008.10.001
language
English
LU publication?
yes
id
da2ded6d-2282-4536-b007-4cc46266cbf7 (old id 1490270)
date added to LUP
2009-10-19 15:30:38
date last changed
2017-10-01 03:46:16
@article{da2ded6d-2282-4536-b007-4cc46266cbf7,
  abstract     = {Objective and Background: Pulse wave amplitude (PWA) derived from the digital vascular bed has been used in sleep studies. The nocturnal attenuation of PWA has been shown to reflect sympathetic activation during sleep. We assessed the relationship between nocturnal PWA attenuation and office blood pressure (BP). Methods: Eighty-one subjects (46 men; age 60 7 years: body mass index [BMI] 28.2 +/- 4.3 kg/m(2); apnea hypopnea index [AHI], 25.4 +/- 22.6 events/h; systolic BP 137 +/- 15 mmHg; diastolic BP 79 +/- 7 mmHg) recruited from a population based cohort underwent simultaneous ambulatory polysomnography (PSG) and peripheral arterial tonometry (PAT) recording. Episodic attenuations of PWA derived from the pulse waveform of the PAT signal were identified and characterized. Generalized least squares regression models were used to identify the associations between median PWA attenuation (PWA.att), office BP and sleep-related disordered breathing. Results: We found that the association between PWA.att and office BP was independent of gender, age, BMI, anti hypertensive medication, number of attenuation episodes, AHI, oxygen desaturation >= 4% index (ODI4) and arousal index. Each 10% increase in PWA.att was associated with increases of 5.0 mmHg systolic BP (P = 0.02) and 3.0 mmHg diastolic BP (P = 0.005). We also found independent relationships between systolic/diastolic BP and BMI (P = 0.0006/0.001), AHI (P = 0.0310.1) and ODI4 (P = 0.03/0.03). Conclusions: The degree of PWA attenuation during the night is associated with office BP independent of sleep-disordered breathing. Continuous assessment of PWA during sleep may provide novel insights into cardiovascular physiology and morbidity. (C) 2008 Elsevier B.V. All rights reserved.},
  author       = {Zou, Ding and Grote, Ludger and Radlinski, Jakub and Eder, Derek N. and Lindblad, Ulf and Hedner, Jan},
  issn         = {1878-5506},
  keyword      = {arterial tone,Peripheral,Body mass index,Autonomic activity,Office blood pressure,Sleep apnea,Pulse wave amplitude,Polysomnography},
  language     = {eng},
  number       = {8},
  pages        = {836--843},
  publisher    = {Elsevier},
  series       = {Sleep Medicine},
  title        = {Nocturnal pulse wave attenuation is associated with office blood pressure in a population based cohort},
  url          = {http://dx.doi.org/10.1016/j.sleep.2008.10.001},
  volume       = {10},
  year         = {2009},
}