CCCardiol CroatCardiologia CroaticaCardiol. Croat.1848-543X1848-5448Croatian Cardiac SocietyCC 2019 14_9-10_23610.15836/ccar2019.236Extended AbstractExcessive daytime sleepiness as cardiovascular risk in Croatian obese patientshttps://orcid.org/0000-0003-2851-6183MustačFilip1*https://orcid.org/0000-0002-6325-7394MatovinovićMartina2https://orcid.org/0000-0002-2791-1379MutakTomislav1https://orcid.org/0000-0002-1665-7491BarunBarbara2https://orcid.org/0000-0002-3189-1518JugJuraj1https://orcid.org/0000-0003-3687-1310LevickiRea3https://orcid.org/0000-0001-8446-6120Lovrić BenčićMartina12https://orcid.org/0000-0002-9262-4667JelakovićAna2https://orcid.org/0000-0002-2546-4632JelakovićBojan12University of Zagreb School of Medicine, Zagreb, CroatiaUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, CroatiaPožega General County Hospital, Požega, CroatiaADDRESS FOR CORRESPONDENCE: Filip Mustač, Susedgradska 3, HR-10000 Zagreb, Croatia. / Phone: +385-91-9232-406 / E-mail: filip.mustac@gmail.com102019149-1023623605082019160920192019Croatian Cardiac SocietyKEYWORDS: excessive daytime sleepinesscardiovascular riskobesityhypertension
Introduction: Excessive daytime sleepiness (EDS) is a very common complaint, especially in obese patients and is a potentially alarming symptom related to many risk factors and comorbidities (1). In obese patients obstructive sleep apnea (OSA) is quite common. Our goal was to assess the connection between EDS and hypertension in Croatian obese patients.
Patients and Methods: This cross-sectional study was carried out in a tertiary healthcare centre in an outpatient clinic for treatment of obesity. 49 participants were included. Inclusion criterion was BMI>30 kg/m2. Epworth Sleepiness Scale (ESS), consisting of 8 questions, every question ranged from 0-3 (overall range 0-24) was used to assess EDS. Spearman correlation coefficient, Welch t-test, chi-squared test and regression analysis were used. They were divided into 4 and 3 categories. 4 categories: 0-7, 8-9, 10-15 and 16-24. Many researches take ESS score 10 or greater as excessive daytime sleepiness, so our results were also interpreted as 3 categories: 0-7, 8-9 and 10 or greater.
Results: Mean age of our participants was 50.29 ± 11.91 years. Overall mean BMI was 44.64±8.12 kg/m2. Results on ESS divided into 4 categories (Figure 1) were statistically significant correlated to hypertension: χ2= 9.61; p = .02. Also, results on ESS in 3 categories (Figure 2) were statistically significant correlated to hypertension: χ2(2) = 9.43; p = .009. Results on ESS were not significantly connected to AHI index (ESS in 4 categories: χ2(9)=8.43, p=.49; ESS in 3 categories: χ2(6)=6.45, p=.37). Furthermore, results on ESS were not correlated to sex (ESS in 4 categories χ2(3)=0.85, p=.84 and ESS in 3 categories: χ2(2)=0.56, p=.76).
Scores on Epworth Sleepiness Scale divided into 4 categories depending on the presence of hypertension.
Scores on Epworth Sleepiness Scale divided into 3 categories depending on the presence of hypertension.
Conclusion: Our results show that the presence of hypertension alters the result on the ESS and is most visible in the so-called “borderline” area for the ESS score 8-9 in both divisions (into 3 and 4 categories), which shows a possible underestimation of the risk of the population achieving the result on the ESS <10, which is consistent with the studies of Borsini et al. (2)
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