Analysis of periodic leg movements during sleep, 24-hour blood pressure and heart rate / [Análisis de movimientos periódicos de piernas durante el sueño, presión arterial de 24 horas y frecuencia cardíaca.]

RESUMEN

Periodic Leg Movements During Sleep (PLMS), diagnosed by polysomnography, is characterized by stereotyped leg movements that appear repetitively at night. Each PLMS is associated with microarousal and increases in heart rate, blood pressure, and sympathetic activity. Objectives: To analyze the association between the pathological index of PLMS and 24-hour BP in normotensive patients.To evaluate the association between the pathological index of PLMS, with alterations in pulse wave velocity and heart rate. Methods: Observational study of cases and controls. 19 normotensive subjects were studied by Nocturnal Polysomnography and Ambulatory Blood Pressure Monitoring. The variables were determined: Age, sex, weight, body mass index. 24-h, diurnal, and nocturnal blood pressure and heart rate were assessed with 24-h ambulatory blood pressure monitoring. Patients with apnea/hypopnea index ≥ 5 e/h were excluded. The variables were described and subjects with and without PLMS were compared, considering significant a p<0.05, in addition to correlation analysis. Results: Eleven patients with pathological PLMS and 7 controls were studied.PLMS Index 35.6±15 versus 7.9±5 respectively. PLMS patients were younger 57±14 versus 64±6; p=0.284. The 24-h blood pressure was lower in the PLMS group than the controls (systolic 114.2±11 versus 123±11; p=0.095; and diastolic 65.7±5 versus 74.4±11, p=0.027). Discussion: We found an unexpected, inverse, statistically significant relationship when correlating pathological-grade periodic leg movements during sleep with 24-hour mean and systolic blood pressure, daytime and nighttime systolic blood pressure, and mean blood pressure. nocturnal, as well as similar findings in the 24-hour pulse pressure and the diurnal and nocturnal pulse pressure that were lower than the control group. We found no changes in heart rate.