Mendoza AVM, Paniagua SR, Kornhauser AC, Kasimierz Wrobel, Malacara HJM, Nava EL

Language: Spanish
References: 49
Page: 159-167
PDF size: 144.34 Kb.

ABSTRACT

The present prospective study longitudinal, experimental and controlled, was carried out with the purpose of analyzing the sympathetic nerve activity in the patient with OSA (habitual snorer with more than 5 apnea obstructive/h) associated to systemic arterial hypertension. 28 subjects were studied of 1 march from 1996 to 1 march of the 2000: Group I: constituted by 14 patients with OSA, treatment with bromocriptine 2.5 mg diary. Group II: constituted for 14 patients with OSA treatment with enalapril 10 mg diary. To all the patients were carried out complete clinical history, were made breathing functional test, prolactina, and catecholamines urine for chromatography liquid of high pressure, determines the pressure of the lung artery for echocardiography Doppler, as well as arterial saturation of oxygen. The patient to be hospitalized by the realization of the mentioned studies, studies that were made before and after treatment with bromocriptine and enalapril. Results: in the group I and II: patient with OSA with average, age 46.0 ± 5.2, IMC 25.3 ± 1.0 was made studies polisomnografic demonstrating an apnea index ± hipopnea inside the inferior limits of 18.7 ± 10.4, the breathing functional tests showed basal restrictive pattern 70.3 ± 4.7 and after to the bromocriptine and enalapril administration the functional tests remained practically without changes appreciating it doesn’t differentiate statistic significant pNS. In the group I and II: the systolic pressure of the lung artery determined by echocardiography, it was elevated in their basal determination 30.4 ± 9.7 for after to the administration of bromocriptine and enalapril remained without changes, not existing difference statistic significant pNS. In the group I the plasmatic prolactina was high basal level 36.7 ± 5.8 and after to treatment with bromocriptine 16.7 ± 2.3 remained inside normal parameters being appreciated a p ‹ 0.001, in the group II the plasmatic prolactina remained risen before and after to enalapril, in the group I the determination of catecholamines plasmatic and urine for liquid chromatography, it was high at basal level, for after to treatment with bromocriptine remained inside the normal parameters existing a p ‹ 0.001, in the group II the determination of catecholamines urine for liquid chromatography of high pressure remained risen before and later to treatment with enalapril. In the group I and II the determination of the arterial pressure at basal level it was high and after to treatment with bromocriptine and enalapril remained inside normal parameters finding difference significant statistic p ‹ 0.01. Conclusions: In the patient with light OSA associated to light systemic arterial hypertension, increment exist in the sympathetic activity at basal level what sustains the probability of an deficiency neuromodelation of the activity dopaminergic and be part of the physiopathology of the hypertension in the patient with OSA and the action of the bromocriptine is probably through of a modulation inhibitory of the sympathetic activity. We conclude that the bromocriptine and enalapril are of utility for the arterial hypertension in the patient with OSA.

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