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Hypertension

By , Missouri City, TX
Abstract:
This article explains how Hypertension can greatly increase one’s risks of developing Sleep Apnea. It also questions whether there is a substantial correlation between the two. Around half the cases of Sleep Apnea are with those who suffer from blood pressure issues. Despite the fact, that there are various ways to acquire Sleep Apnea without Hypertension this is a leading instigator. Luckily, those with Hypertension do not have to maintain this as a lifelong problem instead by taking control of it they can steer away from other possible side effects which can be life threatening. Everyone can be a potential victim for Sleep Apnea but those with Hypertension tend to have a more complicated form of the disorder. Hypertension is a growing problem in our nation and along with it come many more side effects. Sleep apnea is one of the most undiagnosed heath conditions due to its recent findings by becoming more aware of these problems one can learn to take control of a problem that can lead to hundreds more.

Introduction:
One of the most common health problems seen in American Hospitals is Hypertension. Due to the increasing rates of diabetes and obesity, high blood pressure has also increased in an alarming rate. Though common, Hypertension comes with made life threatening side effects such as artery damage, coronary heart disease, stroke etc. Hypertension can cause damage in not only the heart but also the brain, eyes, and kidneys. With the experiment that we have done in class I have chosen to implore on the details of the effects of Hypertension on sleep apnea. Obstructive sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts during sleep. Several types of sleep apnea exist, but the most common type is obstructive sleep apnea, which occurs when your throat muscles intermittently relax and block your airway during sleep. The most noticeable sign of obstructive sleep apnea is snoring. Sudden drops in blood oxygen levels that occur during obstructive sleep apnea increase blood pressure and strain the cardiovascular system. About half of the people who have sleep apnea also have high blood pressure.(NHLBI). Many people with obstructive sleep apnea develop high blood pressure (hypertension), which raises the risk of heart failure and stroke. The more severe the obstructive sleep apnea, the greater the risk of high blood pressure. People with obstructive sleep apnea are much more likely to develop abnormal heart rhythms such as atrial fibrillation. If there's underlying heart disease, these repeated multiple episodes of low blood oxygen (hypoxia or hypoxemia) could lead to sudden death from a cardiac event. "As a result of this study, we now believe that sleep apnea may be one of the reasons why overweight people are at increased risk for high blood pressure," said lead author Javier Nieto, MD, associate professor, Epidemiology, Johns Hopkins School of Public Health.(Parsons). My question is whether the students in my class who have high blood pressure are potentials for sleep apnea? I hypothesize that the students who have marginally high blood pressure are at great risk of sleep apnea if they possess the various other symptoms. Though extensive research has been done in this topic in the recent times due to the lack of medical advancements in the is field, “Sleep problems have been linked to high blood pressure before. Sleep apnea, a chronic disorder in which a person wakes up struggling for breath several times during the night, is strongly linked to hypertension, although it’s not clear whether the disorder causes high blood pressure or vice versa — or whether the two conditions feed each other.(Harding). In fact, in the last two years, seven major studies have shown that OSA is an independent risk factor for hypertension and, generally, the more severe the OSA, the more prevalent and severe the hypertension. In addition, many studies, including four that have been recently published, have shown that successful treatment of OSA is associated with a significant reduction in blood pressure levels, although two other studies did not report similar findings. A recent long-term study also showed that patients with OSA are far more likely to develop hypertension over a four-year period than those without OSA. (Silverberg). In the night, blood pressure is supposed to drop by a good 10 to 20 percent but people with sleep apnea fail to do so and therefore have increased hypertension in the night. Using data from 328 members of the sleep cohort group, the authors showed that people who had sleep apnea or hypo apnea – periods when they stopped breathing or when air flow was greatly reduced, causing blood oxygen levels to drop – often went on to develop "non-dipping" of nighttime systolic blood pressure when researchers tested them again an average of 7.2 years later.(Coxe). Through the accumulation of all this evidence it can be noticed that sleep apnea and hypertension have a close tie to one another and there is an obvious link between the two.

Materials and Methods:
To do this experiment my Anatomy class of around 30 people in order to see how many were at risk for sleep apnea. We used a sphygmomanometer and an assistant. The device is used to calculate blood pressure and must be rested right above the elbow. This machine can calculate both the systolic and diastolic pressure. To measure the systolic and diastolic pressure, pump up the sphygmomanometer then release the pressure, when you first hear a noise record the systolic pressure number and when the noise fades record the diastolic number. We then neatly arranged the data from the class from the lab. We calculated our blood pressure using the machine and then noted it down. To determine blood pressure put the systolic number over the diastolic. Then we compared the numbers to the range of the average blood pressure range to see which students have high blood pressure and which students have low blood pressure.

Results:
Figure 1
A blood pressure around the statistics of 90/60 and 130/85 can be considered healthy for a person. A deviation from these numbers can signal a potential health risk. On the contrary to popular thinking low blood pressure is just as risky as high blood pressure. Moderation is key. In my class four people have high blood pressure with two being extreme hypertension cases while the remaining are borderline. Though only two are marginally higher they still pose the same risk the other two do. In this case the two with the higher blood pressure are most likely sleep apnea candidates while the borderline are possible candidates for sleep apnea. Though no one has low blood pressure there is one person that is a borderline candidate. It is more common to see high blood pressure than low blood pressure. Though these statistics may sound pleasant now they are a horrible indicator for the future. Through Figure 1 it can be seen that there steep variations among the pressures. Typically, hypertension becomes a much bigger problem as one grows older. Especially, since half of Americans have blood pressure my class would be a bad model to substantiate that data.

Discussion:
As stated earlier the current state of blood pressure of students in my class is not a substantial medium to predict their future. Hypertension usually occurs as one ages due to the lack of physical activity and attention towards diet. On the flip side, to those that already have hypertension this young should take extreme precaution as they are more susceptible to the side effects of Hypertension. This could lead to sleep apnea which untreated can also cause death. For those that do have Hypertension, it is recommended that they take more precaution towards their diet and consider various physical activities to engage themselves in. Hypertension does not have to be a lifelong problem if you can learn to control it. Also, just because one has normal blood pressure does not alienate them from the chances of getting Sleep Apnea. Though rare, they can also be possible candidates. In the studies done earlier, it was stated that half of those with Hypertension get Sleep Apnea. Based on that we have two students in my class are full fledged candidates to the disorder. Based on sole evidence my hypothesis is correct yet it is impossible to know the full fledged effects of sleep apnea in my class unless the students go through the apnea testing. We need more resources in order to check the validity of my hypothesis and a larger serving sample would be more effective. The best way to improve this experiment is to get a much larger sampling size with people of different demographics it would also be effective to take those who have a history of Hypertension and have controlled it and see whether sleep apnea still occurs for those patients. It would also be nice to test whether people who do have sleep apnea due to hypertension will see a decrease in their apnea problems if they lower their blood pressure significantly or whether the sleep apnea still sticks to them despite the change in blood pressure. It would also be more effective to test in the night to judge the increase in blood pressure with those with Sleep Apnea.

References:
Coxe M. Sleep Apnea Raises Blood Pressure, UW Health 2008; 65-72.Available from: http://www.uwhealth.org/news/sleep-apnea-raises-blood-pressure-/13516
Harding A. Could lack of Sleep fuel Blood Pressure. Time 2011 Aug. 30;
Available from: http://healthland.time.com/2011/08/30/could-lack-of-deep-sleep-fuel-high-blood-pressure/
National Heart Lung and Blood Insitiute (United States) [NHLBI]. Who is at risk for sleep apnea?. Apnea and Hypertension. Bethesda (MD): National Institute of Health; 2010 Aug 1. 11 p. Available from: http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/atrisk.html
Parsons T. High Blood Pressure linked to Sleep Apnea, Johns Hopkins Bloomberg 2000; 31-36. Accessed 2012 Mar. 5.Available from: http://www.jhsph.edu/publichealthnews/press_releases/PR_2000/apnea_hypertension.html
Silverberg DS, Oksenberg A. Essential and secondary hypertension and sleep disordered breathing: a unifying hypothesis. J Hum Hypertens. 1996;10:353–63.Available From: http://www.aafp.org/afp/2002/0115/p229.html





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