TY - JOUR
T1 - Hypopnea in pediatric patients with obesity hypertension
AU - Reade, Erin Parrish
AU - Craig, Whaley
AU - Lin, Jen Jar
AU - McKenney, Daniel W.
AU - Lee, Daniel
AU - Perkin, Ronald
PY - 2004/9
Y1 - 2004/9
N2 - Obesity is associated with the development of hypertension but it is still not clear why hypertension is not observed in all obese patients. Obesity is a risk factor for the development of obstructive sleep apnea syndrome (OSAS) in children. OSAS has been linked to the development of hypertension in adults and children. The purpose of this study was to test the hypothesis that OSAS is one of the reasons that some obese children are hypertensive and some are not. The overnight polysomnography records of 90 patients (aged 4.2-18.8 years) were reviewed. BMIscore [body mass index (BMI)/95th percentile BMI for age, sex, and race] was used to express the degree of obesity. The severity of systolic hypertension and diastolic hypertension were expressed as SBPscore (systolic BP/the 95th percentile systolic BP for age, sex, and height) and DBPscore (diastolic BP/the 95th percentile diastolic BP for age, sex, and height), respectively. OSAS was defined as more than one episodes of apnea per hour (AI) or an O2 saturation associated with obstructive apnea of less than 90%. There were 56 obese patients; 42 were hypertensive and 40 patients were diagnosed with OSAS. The incidence of hypertension (68% vs. 30%) and obesity (75% vs. 52%) was higher in OSAS patients than those without OSAS. Compared with the non-obese patients, obese patients had a higher incidence of hypertension or OSAS, a higher BMIscore, SBPscore, DBPscore, AI, hypopnea index (HI), and apnea-hypopnea index (AHI). In obese patients, both SBPscore and DBPscore correlated positively with BMIscore, arousal index, and HI. DBPscore also correlated positively with AHI. Multiple regression analysis showed that HI and BMIscore were significant independent predictors of SBPscore or DBPscore. Obese and hypertensive patients had a higher HI, AHI, and incidence of OSAS (64% vs. 29%) than the obese and normotensive patients. In conclusion, HI had a significant correlation with the degree of hypertension in obese patients, which could not be attributed to the degree of obesity. Tflese findings are consistent with the hypothesis that OSAS is one of the reasons why some obese children are hypertensive and some are not.
AB - Obesity is associated with the development of hypertension but it is still not clear why hypertension is not observed in all obese patients. Obesity is a risk factor for the development of obstructive sleep apnea syndrome (OSAS) in children. OSAS has been linked to the development of hypertension in adults and children. The purpose of this study was to test the hypothesis that OSAS is one of the reasons that some obese children are hypertensive and some are not. The overnight polysomnography records of 90 patients (aged 4.2-18.8 years) were reviewed. BMIscore [body mass index (BMI)/95th percentile BMI for age, sex, and race] was used to express the degree of obesity. The severity of systolic hypertension and diastolic hypertension were expressed as SBPscore (systolic BP/the 95th percentile systolic BP for age, sex, and height) and DBPscore (diastolic BP/the 95th percentile diastolic BP for age, sex, and height), respectively. OSAS was defined as more than one episodes of apnea per hour (AI) or an O2 saturation associated with obstructive apnea of less than 90%. There were 56 obese patients; 42 were hypertensive and 40 patients were diagnosed with OSAS. The incidence of hypertension (68% vs. 30%) and obesity (75% vs. 52%) was higher in OSAS patients than those without OSAS. Compared with the non-obese patients, obese patients had a higher incidence of hypertension or OSAS, a higher BMIscore, SBPscore, DBPscore, AI, hypopnea index (HI), and apnea-hypopnea index (AHI). In obese patients, both SBPscore and DBPscore correlated positively with BMIscore, arousal index, and HI. DBPscore also correlated positively with AHI. Multiple regression analysis showed that HI and BMIscore were significant independent predictors of SBPscore or DBPscore. Obese and hypertensive patients had a higher HI, AHI, and incidence of OSAS (64% vs. 29%) than the obese and normotensive patients. In conclusion, HI had a significant correlation with the degree of hypertension in obese patients, which could not be attributed to the degree of obesity. Tflese findings are consistent with the hypothesis that OSAS is one of the reasons why some obese children are hypertensive and some are not.
KW - Hypertension
KW - Hypopnea
KW - Obesity
KW - Sleep apnea
UR - http://www.scopus.com/inward/record.url?scp=4544271481&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=4544271481&partnerID=8YFLogxK
U2 - 10.1007/s00467-004-1513-1
DO - 10.1007/s00467-004-1513-1
M3 - Review article
C2 - 15179571
AN - SCOPUS:4544271481
SN - 0931-041X
VL - 19
SP - 1014
EP - 1020
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 9
ER -
