Iara Felicio Anunciato et al. Rômulo Rebouças Lobo Eduardo Barbosa Coelho Waldiceu Aparecido Verri Jr … Alan Luiz Eckeli Paulo Roberto Barbosa Évora Fernando Nobre Júlio César Moriguti Eduardo Ferriolli Nereida Kilza da Costa Lima
BACKGROUND: The role of oxidative stress in hypertensive elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) is unknown. OBJECTIVE: The purpose was to evaluate the levels of big endothelin-1 (Big ET-1) and nitric oxide (NO) in elderly hypertensive patients with and without moderate to severe OSAHS. METHODS: Volunteers were hospitalized for 24 h. We obtained the following data: body mass index (BMI); 24-ambulatory blood pressure monitoring; and current medication. Arterial blood was collected at 7pm and 7am for determining plasma NO and Big ET-1 levels. Pulse oximetry was performed during sleep. Pearson’s or Spearman’s correlation and univariate analysis of variance were used for statistical analysis. RESULTS: We studied 25 subjects with OSAHS (group 1) and 12 without OSAHS (group 2) aged 67.0 ± 6.5 years and 67.8±6.8 years, respectively. No significant differences were observed between the groups in BMI; number of hours of sleep; 24-h systolic and diastolic BPs; awake BP, sleep BP and medications to control BP between groups. No differences were detected in plasma Big ET-1 and NO levels at 19:00 h, but plasma Big ET-1 levels at 7:00 h were higher in group 1 (p =0.03). In group 1, a negative correlation was also observed between the mean arterial oxyhemoglobin saturation level, 24-h systolic BP (p = 0.03, r = -0.44), and Big ET-1 (p = 0.04, r = -0.41). CONCLUSIONS: On comparing elderly hypertensive patients with and without OSAHS having similar BP and BMI, we observed higher Big ET-1 levels After sleep in the OSAHS group. NO levels did not differ between the hypertensive patients with or without OSAHS.