Predictors of Sleep Disorders in Patients With Hypertension

Abstract

The aim of the study was to study the features of the daily profile of blood pressure (BP) and endothelial function in patients with hypertension (GB) with sleep disorders. The study included 67 male patients with stage II GB, who were divided into 3 groups: with the absence of sleep disorders, with single and combined forms of sleep disorders. Patients underwent daily blood pressure monitoring (SMAD) and endothelial function assessment by determining the concentration of nitric oxide metabolites in daily urine and a test with reactive hyperemia using high-resolution ultrasound (7 MHz). Analysis of the SMAD data showed that patients with combined sleep pathology had the highest indicators of systolic and diastolic blood pressure, both during the day and at night, as well as a high level of morning blood pressure rise. In addition, patients with combined forms of sleep disorders were more likely to have violations of the circadian rhythm of blood pressure in the form of a pathological type of "night - peaker". A comparative assessment of the endothelial vasomotor function in patients with combined forms of sleep disorders revealed the highest percentage of paradoxical vasoconstriction (75%), when no such type of vasoconstriction was found in the group without sleep disorders. At the same time, the indicators of endothelium-dependent vasodilation and the level of nitric oxide metabolites in patients with GB with combined sleep pathology were significantly lower than in the group without sleep disorders. Thus, sleep disorders in patients with GB are associated with pathological indicators of SMAD and endothelial dysfunction.