Ambulatory blood pressure monitoring in patients with chronic obstructive pulmonary disease with sleep desaturation / Monitorização ambulatorial da pressão arterial em portadores de doença pulmonar obstrutiva crônica com dessaturação no sono

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Introduction: The hypoxemia during the sleep period can, by a sympathetic activation mechanism, change the blood pressure. Few studies show the alterations of the blood pressure, during the sleep period, in chronic obstructive pulmonary disease patients that do not have sleep apnea, but do desaturate during this period. Objective: To analyze the arterial pressure variation in chronic obstructive pulmonary diseased patients that have nocturnal desaturation, not caused by apnea. Methods: Thirteen chronic obstructive pulmonary diseased patients were submitted to spirometry, arterial gasometry, polysomnography and a 24-hour Ambulatory Blood Pressure Monitoring (ABPM) to evaluate the pressure variations. Fourteen patients who do not have the chronic obstructive pulmonary disease were submitted to spirometry, to oxymetry and to a 24-hour arterial pressure ambulatory monitoring. The arterial pressure analyses were made both in vigil and in sleep time. Both groups consisted of patients without hypertensive antecedents. Results: The two groups were similar in terms of age, height, weight and body mass index. There was a significant difference (p <0,05) among the pressure parameters in the vigil, sleep, 24-hour and sleep dipper periods. There was a drop in the sleep dipper in COPD group: 4.38% and 6.0% respectively for systolic and diastolic values, while the control group showed physiological sleep dipper of 14.0% and 16.21%.The average systolic in vigil were higher in COPD group than in the control group: SBP = 132.69 12.61 mmHg in COPD group and SBP= 120.29 10.20 mmHg in the control group, with P = 0009. There were no significant differences in mean DBP in vigil. During sleep period, the average SBP were higher in COPD group than in the control group, with values of SBP= 126.46 10.76 mmHg and DBP= 70.77 6.92 mmHg in COPD group and SBP = 103.86 13.6 mmHg and DBP= 62.14 mm Hg in the control group with P= 0.0001 in SBP and P= 0016 in DBP. The average values measured in 24 hours showed significant difference only in SBP (P = 0002) among the two groups: COPD group with SBP= 131.15 11.53 mm Hg and DBP= 74.62 7.30 mmHg, and control group with averages of 116.79 10.18 mmHg in SBP and 71.00 10.17 mmHg in diastolic blood pressure. In the morning period, the average values of SBP and DBP were statistically higher in the COPD group, as SBP = 138.85 13.10 mmHg and DBP = 81.58 10.78 mmHg in COPD group and SBP = 113.93 9.35 mmHg and DBP = 67.36 11.53 mmHg in the control group (P = 0.0001 for SBP and P = 0.004 for DBP). Conclusion: The systolic and diastolic arterial pressure results were higher in the COPD group than in the control group. The significance of this statement has occurred during all the surveyed periods, except in the vigil and in the 24 hours for the diastolic pressure levels. In this study, it can be concluded that the COPD carrier group with nocturnal desaturation has arterial pressure levels higher than the control group.

ASSUNTO(S)

dessaturação no sono descenso do sono ciencias da saude sleep dipper monitorização ambulatorial da pressão arterial chronic obstructive pulmonary disease ambulatory blood pressure monitoring sleep desaturation doença pulmonar obstrutiva crônica

ACESSO AO ARTIGO

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