SAN ANTONIO — Hypertension in children and adolescents may constitute a novel risk factor for sleep-disordered breathing, Dr. Alisa A. Acosta said at a meeting of the American Heart Association Council for High Blood Pressure Research.
“At this point, there is no indication to refer patients with only hypertension for a sleep study. However, our study does reinforce recommendations from the National Heart, Lung, and Blood Institute's working group for blood pressure in children and adolescents to screen for sleep-disordered breathing risk factors in pediatric patients with systemic hypertension, especially if they're obese.” according to Dr. Acosta of the University of Texas, Houston.
At the university's pediatric hypertension clinic, physicians have begun routinely screening hypertensive patients for sleep-disordered breathing (SDB) risk factors and symptoms. If positive for even one, the patient is referred for a sleep study, as were 26 of the last 350 (7%) screened patients.
Of those 26 patients (mean age 12.6 years), 20 actually underwent overnight polysomnography, of whom 12 (60%) proved to have some form of SDB. Eight patients had obstructive sleep apnea, defined as more than one obstructive apnea episode per hour. Three patients had obstructive hypoventilation, diagnosed by a maximum PCO2 greater than 53 torr during sleep and/or greater than 50 torr during more than 10% of sleep. One patient had hypopnea, marked by a greater than 50% reduction in airflow with a 4% decrease in oxygen saturation and/or a 25% drop in heart rate.
In contrast to the observed 60% prevalence of SDB in this study, the prevalence in the general pediatric population has been estimated at 2%–3%.
Sixty percent of the hypertensive patients who underwent polysomnography had some form of SDB. DR. ACOSTA