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Master Thesis

Nycturie, un facteur prédictif indépendant d’hypertension artérielle prévalente chez les patients souffrant d’un syndrome d’apnée obstructive du sommeil : une étude de cohorte prospective nationale

Abstract : Importance: Nocturia, a common complaint in Obstructive Sleep Apnea (OSA) patients is linked, in the general population, to an increased risk of hypertension and mortality. The specific role of nocturia in OSA-related hypertension has not been studied. Objective: To determine whether nocturia is an independent predictor for prevalent hypertension after adjustment for confounders in a national OSA registry. Design, Settings and Participants: We analyzed data from a national prospective clinical cohort of obstructive sleep apnea patients participating in the French national prospective registry (Observatoire Sommeil de la Federation de Pneumologie). Anthropometric data, medical history, co-morbidities, OSA severity and number of voids/night were included in multivariate analysis to determine the independent variables associated with prevalent hypertension. Results: 22,674 OSA patients were included, 11,332 (49.98%) were hypertensive. The prevalence of hypertension among OSA patients was about 1.3 times higher in patients suffering from nocturia, with a prevalence of nocturia of 61.45% versus 46.52% in hypertensive and in non-hypertensive OSA patients respectively (p<0.001). Moreover, there was a significant positive relationship between prevalent hypertension and the severity of nocturia: 1 void/night versus 0: OR=1.284 (95%CI=1.184; 1.393), 2 voids/night versus 0: OR=1.270 (CI95%=1.175; 1.372), 3 voids/night versus 0: OR=1.422 (95%CI=1.293; 1.565) and 4 voids/night versus 0: OR=1.575 (95%CI=1.394; 1.781). The strength of the association was enhanced for OSA patients over the age of 64 years. Morever, prevalent hypertension was associated with being older, a higher BMI, cardio-vascular co-morbidities (coronary heart disease, arrhythmias, stroke, diabetes and dyslipidemia). Conclusion and Relevance: Nocturia is a strong independent predictor of prevalent hypertension in OSA patients. This association exhibited a ‘dose-response’ relationship and was found for all age strata. The resolution of nocturia after continuous positive airway pressure (CPAP) treatment might be an important outcome to consider for the response of blood pressure to CPAP therapy and the risk of long term cardiovascular adverse events.
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Master Thesis
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Marie Destors. Nycturie, un facteur prédictif indépendant d’hypertension artérielle prévalente chez les patients souffrant d’un syndrome d’apnée obstructive du sommeil : une étude de cohorte prospective nationale. Médecine humaine et pathologie. 2014. ⟨dumas-01103900⟩

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