Correlação entre a gravidade da síndrome da apnéia e hipopnéia obstrutiva do sono, a hipertensão arterial sistêmica e os níveis séricos lipídicos e glicêmicos

Abstract

INTRODUCTION: Characterized by recurrent episodes of partial or total obstruction of the upper airway during sleep apnea syndrome and obstructive sleep hypopnea syndrome (OSAHS) is the most common form of sleep-related breathing disorder that is considered an important cause of morbidity and mortality. The intermittent hypoxia and reoxygenation are increasing the activity of the sympathetic nervous system, on the other hand increase the blood pressure, altering the oxidative balance, inducing the formation of free radicals and consequent atherogenesis. The disease is classified in level of severity the according to the quantification of respiratory events per hour of sleep (AHI - apnea-hypopnea) as light, when they occur 5 to 15 events / hour sleep, moderate, 15 to 30 , and severe above 30. OBJECTIVE: This study was performed to verify the correlation between the severity of OSA, blood pressure in 24 hours, during waking and sleep, and serum lipids and glucose. MATERIAL AND METHOD: We studied 32 patients. These were assessed by completing a questionnaire, in addition to being weighed and measured. In the first assessment, was checked blood pressure (BP), the examination and ENT requested laboratory tests, including total cholesterol, LDL, HDL, triglycerides, total lipids and fasting glucose, polysomnography and ambulatory blood pressure monitoring (ABPM). Patients were divided into four groups according to the AHI: control group (AHI <5), Group I (AHI 5-15), Group II (AHI 15-30), Group III (AHI> 30). RESULTS: There was no significant variation with respect to mean age between cases and controls (p = 0.749) and with a body weight (p = 0.075), despite having been an increase of body mass directly proportional to the severity of the disease. There was no statistically significant difference between groups with respect to the first assessment of BP (p = 0.339 for systolic and p = 0.238 for diastolic BP). There was no increase in blood pressure in groups’ cases, the verification of systolic (p = 0,429) and diastolic (p = 0,475) blood pressure in 24 hours, systolic (p = 0,277) and diastolic (p = 0,143) blood pressure during wakefulness, and systolic (p = 0,394) and diastolic (p = 0,703) blood pressure during sleep in the control group. When implementing the Spearman correlation test, was not observed a correlation directly proportional to the severity of the disease. Regarding the level of serum total cholesterol (p = 0,092), LDL (p = 0,242), HDL (p = 0,517), triglycerides (p = 0,947), total lipids (p = 0,602) and glucose (0,355), there was no statistically significant difference between groups (p> 0.05 for all parameters), there is a correlation between their values and severity of obstructive sleep apnea. CONCLUSION: there is no correlation between the severity of apnea and hypopnea syndrome Obstructive Sleep and blood pressure levels in 24 hours, during daytime, during the sleep and serum levels of LDL and HDL cholesterol.