Publications of Faculty of Medicine:Hyperhomocysteinemia And Obesity In Obstructive Sleep Apnea Patients As Risk Factors For Development Of Hypertension : A Preliminary Comparative Prospective Study: Abstract

Objectives : To evaluate plasma homoctisteine (Hcyst) in obstructive sleep apnea (OSA) patients with or without hypertension (HT) in comparison to controls free of both OSA and HT and hypertensive patients free of OSAS so as to determine the predictability of various parameters for the probability of development of HT. Patients & Methods : The study included 20 OSAS patients free of HT (OSAS group), another 20 hypertensive OSAS patients (OSAS+HT group) and 20 hypertensive patients but were fire of OSAS (HT group), and 20 volunteers free of OSAS and HT as negative control group. All patients and controls underwent determination of demographic data, complete otorhinolaryngologic examination and sleep-history data including daytime sleepiness using the Epworth Sleepiness Scale (ESS). Then patients and controls underwent measurement of systolic and diastolic blood pressures and calculation of the mean arterial BP (MAP) and pulse oximetry for evaluation of sleep peripheral arterial oxygen saturation (Sa02), determination of frequency of desaturation episodes. All patients and controls gave fasting blood samples for estimation of plasma Hcyst levels. Results: OSAS patients, with or without HT had significantly higher body mass index (BMI) cons pared both to controls and HT groups, while blood pressure measures were significantly higher in all patients groups compared to control group and in OSAS patients compared to HT patients with significan tly higher measures in OSAS+HT group compared to OSAS groups. Mean ESS score was significantly higher and oxygen saturation was significantly lower in all OSAS patients compared to both control and HT groups. Mean serum Hoist levels were significantly higher in patients compared to controls and in OSAS+HT compared to HT and OSAS patients. For all studied patients, there was a positive significant correlation between BMI and MAP and ESS score, and a negative significant correlation with lowest Sa02, while serum Hcyst levels showed a positive significant correlation with MAP, ESS score and 5a02 score, and a negative significant correlation with lowest Sa02. ROC curve analysis defined BMI as significant sensitive parameter serum Hcyst and estimated lowest 5402 were significant specific parameters for defining OSAS patients liable to have MAP a90unsing. Conclusion : There was a close relationship between OSAS and hypertension and BMI and serumt homocysteine levels were found to be significant screening and diagnostic parameters, respectively, for the liability of having MAP 290 mmHg. Considering hyperhomocysteinemia, obesity, and OSAS are treatable entities, as previously documented in literature, it is advisable to screen for the presence of these entities in high risk people especially those susceptible to cardiovascular disease so as to break that vicious circle as a prophylactic and/or therapeutic measure Key words: OSAS, Hypertension, BMI, Hyperhomocysteinemia