Untreated Childhood Sleep Apnea
May Predict Cardiac Disease
A recent study led by researchers at Cincinnati Children's Hospital Medical Center finds that children with sleep disordered breathing (SDB) show increases in several ambulatory blood pressure measures and that these increases can lead to left ventricular remodeling.
According to the study's lead author, Raouf Amin, MD and director of the Division of Pulmonary Medicine at Cincinnati Children's, this association between left ventricular remodeling and 24-hour blood pressure highlights the role of sleep disordered breathing in increasing cardiovascular morbidity.
Using ambulatory monitoring, Dr. Amin and associates measured activity-adjusted morning blood pressure surge, blood pressure load, and diurnal and nocturnal blood pressure in 140 children who had either mild SDB [apnea-hypopnea index (AHI) below 5], severe SDB (AHI 5 or higher) or no SDB (controls).
The study, published in the January issue of Hypertension, finds that:
- Morning blood pressure surge was significantly higher in those children with either mild or severe SDB than healthy controls.
- In children with severe SDB, systolic, diastolic and mean arterial blood pressures were also significantly higher than healthy controls.
- Children with severe SDB had higher relative ventricular wall thickness than healthy controls.
In designing this study, investigators found that SDB has a significantly greater effect than BMI on nocturnal diastolic blood pressure, providing evidence that SBD is associated with increases in 24-hour blood pressure parameters independent of a child's BMI.
Dr. Amin and colleagues conclude from these findings that blood pressure parameters are significant predictors of cardiac remodeling in children with severe SDB.
