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May 10, 2026SLEEP0 citations

0996 Cardiovascular Crisis Signal: Hypoxic Burden is the Critical Biomarker Linking Intermittent Hypoxemia to Sustained BP Elevation

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GBGabriela BritoPSPaula Alana Morais SeixasLMLaís Mota

Key Result

Hypoxic burden was significantly correlated with systolic (r=0.559, p=0.030) and diastolic (r=0.339, p=0.038) blood pressure in patients with obstructive sleep apnea.

Key Points

  • To evaluate the relationship between hypoxic burden and blood pressure levels in individuals diagnosed with obstructive sleep apnea.
  • Cross-sectional study within a cohort of 36 individuals diagnosed with obstructive sleep apnea.
  • Blood pressure (systolic and diastolic) and hypoxic burden measurements were collected and analyzed.
  • Mean age of participants was 53.95 years, with 58.1% being women.
  • Positive correlation found between hypoxic burden and systolic blood pressure (r = 0.559; p = 0.030).
  • Positive correlation observed between hypoxic burden and diastolic blood pressure (r = 0.339; p = 0.038).
  • Mean DBP and SBP significantly differed between patients with elevated hypoxic burden compared to those without.

Study Design

Type

Cross-Sectional (n=36)

Structured PICO

Does Hypoxic Burden correlate with elevated systolic and diastolic blood pressure in patients with Obstructive Sleep Apnea?

P
Population
36 individuals diagnosed with Obstructive Sleep Apnea (OSA), 58.1% women, mean age 53.95 + 11.86 years.
I
Intervention
Hypoxic Burden (HB) measurement (area under the oxyhemoglobin desaturation curve greater than 3%)
C
Comparator
Patients without elevated Hypoxic Burden
O
Outcome
Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) measurementssurrogate

Hypoxic burden is significantly correlated with elevated systolic and diastolic blood pressure in patients with obstructive sleep apnea, suggesting it is a relevant biomarker for cardiovascular risk.

Main Result

Effect estimate: r = 0.559 (SBP), r = 0.339 (DBP)

p-value: p=0.030 (SBP), 0.038 (DBP)

Abstract

Abstract Introduction Obstructive Sleep Apnea (OSA) is associated with chronic sympathetic activation and an increased cardiovascular risk, including sustained elevation of blood pressure (BP). Hypoxic Burden (HB) has been proposed as a quantitative indicator of the intensity and duration of hypoxemia during sleep, which may more accurately reflect the hemodynamic alterations related to OSA. Objective: To evaluate the association between the Hypoxic Burden and blood pressure levels in patients with OSA. Methods Methods: This was a cross-sectional study nested within a cohort evaluating 36 individuals, 58.1% of whom were women, with a mean age of 53.95 + 11.86 years. Patients diagnosed with OSA were included. Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) measurements (mmHg) were collected, along with the Hypoxic Burden, measured using the formula considering the area under the oxyhemoglobin desaturation curve greater than 3%. Results Results: A predominance of Pardo (mixed-race) individuals was observed (n = 18; 41.9%). The mean Body Mass Index (BMI) was 30.77 + 8.06 kg/m². Mean SBP was 133.00 + 21.11 mmHg and mean DBP was 82.67 + 13.48 mmHg. A positive correlation was found between HB and SBP values (r = 0.559; p = 0.030). Similarly, a significant positive correlation was observed between HB and DBP (r = 0.339; p = 0.038). A difference in mean DBP was observed between patients with and without elevated Hypoxic Burden: 80.4 + 10.1 mmHg and 86.3 + 15.7 mmHg, respectively. The same pattern was noted for mean SBP: 125.8 + 15.7 mmHg and 138.1 + 19.4 mmHg, respectively. Conclusion Conclusion: Our study establishes that Hypoxic Burden (HB) is the primary quantifiable driver of blood pressure dysfunction in Obstructive Sleep Apnea (OSA). The significant and positive correlation observed between HB and both systolic and diastolic blood pressure levels (SBP, DBP) strongly suggests that the intensity of intermittent hypoxemia is a superior and more biologically relevant indicator of cardiovascular risk than the mere event count (AHI). Support (if any)

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Cite This Study

Brito et al. (2026) conducted a cross-sectional in Obstructive Sleep Apnea (OSA) (n=36). Hypoxic Burden vs. Without elevated Hypoxic Burden was evaluated on Association between Hypoxic Burden and blood pressure levels (r = 0.559 (SBP), r = 0.339 (DBP), p=0.030 (SBP), 0.038 (DBP)). Hypoxic burden was significantly correlated with systolic (r=0.559, p=0.030) and diastolic (r=0.339, p=0.038) blood pressure in patients with obstructive sleep apnea.

synapsesocial.com/papers/6a0021e6c8f74e3340f9cdd4https://doi.org/10.1093/sleep/zsag091.0995
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