A sleep apnoea questionnaire predicts organ damage in hypertensive patients

Valeria Bisogni, Martino F. Pengo, Giuseppe Maiolino, Maurizio Cesari, Silvia Lerco, Giacomo Rossitto, Antonio Concistrè, Luigi Petramala, Claudio Letizia, Teresa Maria Seccia, Gian Paolo Rossi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Arterial hypertension is associated with obstructive sleep apnoea, poor quality and duration of sleep, which might contribute to hypertension-mediated organ damage. Methods: We investigated the presence of insomnia, restless legs syndrome, and obstructive sleep apnoea using validated questionnaires (Insomnia Severity Index, Restless Legs Syndrome Rating Scale, and STOP-Bang), and their relationship with hypertension-mediated organ damage, in hypertensive patients. Results: In 159 consecutive consenting hypertensive patients [age 47(11) years, median and (interquartile range), body mass index 25.5(5.9) kg/m 2 , office systolic and diastolic blood pressure 144(23)/92(12) mmHg], the STOP-Bang, but not the other scores, predicted cardiac remodelling: compared to patients with a STOP-Bang score < 3, those at high risk of obstructive sleep apnoea showed higher left ventricular mass index [49.8(11.9) vs. 43.3(11.9) g/m 2.7 , p < 0.0001], left atrium volume [25.7(2.5) vs. 25.0(2.8) ml/m 2 , p = 0.003], and aortic root diameter [33.6(3.0) vs. 33.0(3.7) mm, p < 0.0001]. They did not differ for microalbuminuria and estimated glomerular filtration rate. At multivariate analysis, after adjustment for office systolic blood pressure values, the STOP-Bang score remained a predictor of left ventricular mass index; while the Insomnia Severity Index and restless legs syndrome risk score had no predictive value. However, a significant interaction between STOP-Bang and Restless Legs Syndrome Rating Scale scores in determining left ventricular remodelling was found. Conclusions: In consecutive hypertensive stage I patients the STOP-Bang questionnaire allowed identification of a high-risk cohort featuring a more prominent cardiac damage. Hence, this inexpensive tool can be useful for risk stratification purposes in municipalities with limited access to health care resources.

Original languageEnglish
Pages (from-to)173-183
Number of pages11
JournalBlood Pressure
Volume28
Issue number3
DOIs
Publication statusPublished - May 4 2019

Keywords

  • hypertension
  • hypertension-mediated organ damage
  • insomnia
  • Obstructive sleep apnoea
  • restless legs syndrome

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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