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Use of Ambulatory Blood Pressure Monitoring for the Screening of Obstructive Sleep Apnea
Authors:Gerard Torres MD  Manuel Sánchez‐de‐la‐Torre PhD  Montserrat Martínez‐Alonso PhD  Silvia Gómez MD  Oscar Sacristán MD  Jacint Cabau MD  Ferran Barbé MD
Affiliation:1. Cardiovascular Risk Unit, Santa Maria Hospital, Lleida, Spain;2. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain;3. Sleep Unit, Santa Maria Hospital, Lleida, Spain;4. Respiratory Department, Hospital Arnau de Vilanova, Lleida, Spain;5. Institut de Recerca Biomédica de Lleida (IRB Lleida), University of Lleida, Catalonia, Spain
Abstract:Obstructive sleep apnea (OSA) is a frequent and underdiagnosed disease in hypertensive individuals who experience cardiovascular events. The aim of this study was to define the best model that combined the ambulatory blood pressure (BP) monitoring (ABPM), anthropometric, sociodemographic, and biological variables to identify moderate to severe OSA. A total of 105 ABPM‐confirmed hypertensive patients were evaluated using their clinical histories, blood analyses, ABPM, and home respiratory polygraphic results. A multivariate logistic regression analysis was performed to identify the significant variables. The best model included sex, presence of obesity (body mass index ≥30 kg/m2 and abdominal obesity), mean daytime BP, mean nocturnal heart rate, and minimal diastolic nighttime BP to achieve an area under the curve of 0.804. Based on this model, a validated scoring system was developed to identify the patients with an apnea‐hypopnea index ≥15. Therefore, in untreated hypertensive patients who snored, ABPM variables might be used to identify patients at risk for OSA.
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