Abstract
Introduction: Obstructive Sleep Apnea (OSA) is associated with cardiovascular morbidity including hypertension. Beyond the severity of nocturnal hypoxia, others factors such as metabolic abnormalities but also sedentary behaviors and insufficient physical activity may contribute to elevated blood pressure (BP). To clarify the respective role of these factors as determinants of BP in OSA patients, we examined the relationship between BP and anthropometrics, severity of sleep apnea and objectively measured physical activity and sedentary behaviors.
Methods: Ninety-five adults presenting with OSA (Apnea-Hypopnea Index (AHI) >10 events/hr) and high cardiovascular risk (63.3±8.8 years; BMI: 29.9±4.9 kg/m2; AHI: 41.3±17.5/hour; cardiovascular risk SCORE: 13.5±3.7) were included. Physical activity and sedentary behaviors were objectively assessed by actigraphy and self-measured home BP monitoring was measured. Logistic regression models adjusted for sex, age and BMI were built to identify the predictors of self-measured morning and evening BP.
Results: Physical activity was significantly related to obesity but not with the severity of sleep apnea or sleepiness. Sedentary behaviors were associated with self-measured morning and evening systolic BP (r=0.32; p=0.0021; r=0.29; p=0.0043). Steps per day were inversely associated with evening BP (r=-0.27; p=0.0095). Univariate analysis identified steps per day and time spent in vigorous physical activity as determinants for evening self-measured BP. In multivariate analysis, only steps per day were identified as a significant determinant of evening BP.
Conclusion: Physical activity is the major determinant for evening BP in adults with OSA presenting high cardiovascular risk. Our results emphasize the need for lifestyle counseling programs in combination with CPAP to encourage regular physical activity in OSA subjects and obtain better BP control.
Footnotes
- Monique Mendelson, moniquemendelson1{at}gmail.com, UF Recherche sur l'Exercice, CHU Grenoble, Hôpital Sud, Avenue Kimberley, 38434 Echirolles, France, Tel: +33 4 76 76 58 45
↵§ Both authors are corresponding authors.
This study was supported by a grant from Initiatives pour la Santé.
- Copyright © 2013 by Daedalus Enterprises Inc.