Features of daily blood pressure profile and endothelial function in patients suffering from hypertension and insomnia

The purpose of our study was to investigate some features of a daily profile of arterial blood pressure (ABP) and endothelial function of patients with hypertension (H) and insomnia. 42 males with Stage II hypertension were studied. The patients were broken down into 3 groups: those without insomnia, with single and combinative types of sleep disorders. The patients were subjected to daily ABP monitoring (DABPM), with their endothelial function evaluated by determining the concentration of nitric oxide metabolites in daily urine and by testing reactive hyperemia by means of high-resolution ultrasound (7 MHz). DABPM data analysis demonstrated that the patients with combinative sleep disorders had the highest values of systolic and diastolic ABP both in the daytime and at night, as well as a high level of ABP rise in the morning. In addition, diurnal ABP cycle disturbances, like «night-peaker» pathologies, were more frequently observed in patients with combinative sleep disorders. A comparative analysis of the endothelium vasomotor function revealed the highest percentage of paradoxical vasoconstriction (75%) in the patients with combinative sleep disorders and no signs of vasoconstriction in the group without such sleep disorders. The endothelium-dependent vasodilatation signs and the level of nitric oxide metabolites in H patients with combinative sleep disorders were found to be considerably lower than those in patients without such disorders. Thus, sleep disorders in H patients are associated with pathological data of DABPM and endothelial dysfunction.