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Titolo:
The hypercoagulable state in sleep apnea is related to comorbid hypertension
Autore:
von Kanel, R; Le, DT; Nelesen, RA; Mills, PJ; Ancoli-Israel, S; Dimsdale, JE;
Indirizzi:
Univ Calif San Diego, Dept Psychiat, La Jolla, CA 92093 USA Univ Calif SanDiego La Jolla CA USA 92093 ychiat, La Jolla, CA 92093 USA Univ Calif San Diego, Dept Pathol, La Jolla, CA 92093 USA Univ Calif San Diego La Jolla CA USA 92093 Pathol, La Jolla, CA 92093 USA Vet Affairs San Diego Hlth Care Syst, San Diego, CA USA Vet Affairs San Diego Hlth Care Syst San Diego CA USA San Diego, CA USA
Titolo Testata:
JOURNAL OF HYPERTENSION
fascicolo: 8, volume: 19, anno: 2001,
pagine: 1445 - 1451
SICI:
0263-6352(200108)19:8<1445:THSISA>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
FIBRIN D-DIMER; TISSUE-PLASMINOGEN ACTIVATOR; ISCHEMIC-HEART-DISEASE; VON-WILLEBRAND-FACTOR; RISK-FACTORS; PLATELET ACTIVATION; BLOOD-PRESSURE; MENTAL STRESS; FACTOR-VIII; COAGULATION;
Keywords:
blood coagulation; D-dimer; hypertension; obstructive sleep apnea; sympathetic nervous system; thrombin/antithrombin III complex; von Willebrand factor;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
47
Recensione:
Indirizzi per estratti:
Indirizzo: Dimsdale, JE Univ Calif San Diego, Dept Psychiat, 9500 Gilman Dr, La Jolla, CA 92093 USA Univ Calif San Diego 9500 Gilman Dr La Jolla CA USA 92093 USA
Citazione:
R. von Kanel et al., "The hypercoagulable state in sleep apnea is related to comorbid hypertension", J HYPERTENS, 19(8), 2001, pp. 1445-1451

Abstract

Objective Obstructive sleep apnea (OSA) is associated with increased prevalence of atherosclerotic disease. A hypercoagulable state thought to underly atherosclerosis has been described in both OSA and systemic hypertension. We wondered about the respective contribution of apnea and hypertension toa hypercoagulable state. Design Eighty-seven subjects with symptoms suggestive of OSA, mean age 47 years (range 32-64 years), underwent polysomnography and blood pressure (BP) screening. OSA was diagnosed when respiratory disturbance index (RDI) greater than or equal to 15. Subjects having systolic BID (SBP) > 140 mmHg and/or diastolic BP (DBP) > 90 mmHg were classified as having hypertension. Three hypercoagulability markers were measured: thrombin/antithrombin III complex (TAT), fibrin D-dimer (DD), and von Willebrand factor antigen (vWF:ag). Results Analysis of variance and multiple linear regression were performedon the following four subject groups: (1) normotensive non-apneics (n = 19),(2) normotensive apneics (n = 38),(3) hypertensive non-apneics (n = 11), and (4) hypertensive apneics; (n = 19). OSA (groups 2 and 4) had no significant main effect on hemostasis. Hypertensives (groups 3 and 4) had higher plasma levels of TAT (median/inter-quartile range, 148/59-188 versus 77/53-108 pmol/l; P = 0.009) and of DD (376/265-721 versus 303/190-490 ng/ml; P = 0.040) than normotensives (groups 1 and 2). Across all subjects, SBP was the only significant predictor of TAT (P = 0.001) and of DD (P= 0.004), whereas DBP was the only significant predictor of vWF:ag (P = 0.029). These findings persisted even after controlling for gender, age, body mass index, RDI, mean SaO2, and hematocrit. Conclusion Hypercoagulability in OSA is mediated by comorbid hypertension and might account for high cardiovascular morbidity in OSA in general.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/04/20 alle ore 23:53:34