ESPN 50th Annual Meeting

ESPN 2017


 
Do children with hypertension and snoring have severe OSAS?
GEORGIA MALAKASIOTI 1 EMMANOUEL ALEXOPOULOS 1 ANNA-MARIA MYLONA 1 KONSTANTINOS GOURGOULIANIS 1 ATHANASIOS KADITIS 1

1- LARISSA UNIVERSITY HOSPITAL, LARISSA, GREECE
 
Introduction:

Blood pressure elevation is an OSAS-associated morbidity which is apparent mostly in children with apnea-hypopnea index (AHI)>5 episodes/h (moderate-to-severe OSAS). We aimed to evaluate systolic or diastolic hypertension (≥95th percentile for age, gender and height; Pediatrics 2004;114:555) as predictors of AHI>5 in children with snoring.

Material and methods:

Retrospective cohort of children aged ≥5 years with snoring and adenotonsillar hypertrophy and/or obesity who were referred for polysomnography (PSG) over 10 years. Blood pressure (BP) was measured X3 in the morning after polysomnography and percentiles were calculated for average systolic and diastolic BP. Logistic regression was applied to assess the association of systolic or diastolic hypertension with AHI>5 adjusted for body mass index z-score and age.

Results:

Data of 598 children with snoring (median age 6.6 years;range 5-15.1;26.8% obese) were analyzed. Prevalence of systolic or diastolic hypertension was 9.4% and 8.4%, respectively and frequency of AHI>5 was 16.7%. Systolic hypertension was a significant predictor of moderate-to-severe OSAS (OR 2.1; 95% CI 1.1-4.1;P=0.02), but diastolic hypertension was not (OR 1.2; 0.6-2.5; P>0.05). The odds of AHI>5 prior to considering systolic hypertension was 0.20 and after considering its presence increased to 0.40 (Bayes theorem), i.e. for every 6 children with snoring undergoing PSG, 1 had AHI>5, while for every 4 children with systolic hypertension and snoring tested, 1 was found to have AHI>5.

Conclusions:

In the context of systolic hypertension and snoring in an otherwise healthy child, referral for PSG to rule out moderate-to-severe OSAS seems to be clinically appropriate.