0438 Obstructive sleep apnoea in patients with stroke verses those with refractory hypertension search for common pathogenic mechanism
Bibliographic record
Abstract
Abstract Introduction Obstructive sleep apnea [OSA] is a risk factor for stroke and refractory hypertension [RH]. OSA causes disrupted sleep, intermittent hypoxia, and hypoxia-induced systemic inflammation and sympathetic activation are potential pathogenic mechanisms for the first ever stroke and refractory hypertension. The aim of the present study was to evaluate sleep quality among OSA among patients with first ever stroke, as compared to RH and to assess markers of sympathetic activation and systemic inflammation in patients with either stroke or RH. Methods All patients with stroke and RH were recruited from the Departments of Neurology and Cardiology, respectively at the All India Institute of Medical Sciences, New Delhi. All patients were interviewed for demographic details, clinical history and were scheduled for polysomnography. Fasting blood samples were collected during morning hours, to estimate biochemical markers [Norepinephrine, CRP, TNF-∞, VGEF and IL6] . CRP, TNF-alpha, and IL-6], measured by the chemiluminescence method. Nor-adrenaline and VEGF were measured using ELISA techniques. Results A total of 114 stroke patients and 56 refractory hypertension patients were included. The prevalence of OSA among stroke and RH patients was found to be 86.85 and 81% respectively. The mean number of wake after sleep onset periods (WASOs) [45±19.22 vs 29.8±11.14, p< 0.01]was significantly higher in patients with stroke. REM AHI [240.04±24.65 vs 33.20±22.35, p< 0.01] was significantly higher in patients with RH.CRP and VEGF values were higher than normal, in both groups. The median value of early morning serum nor-adrenaline was higher in the RH group[407 (66.6-1000) vs 515 (240-1250), p = 0.05]. Conclusion OSA is highly prevalent among the patients in both groups. Systemic inflammation is a common pathogenic mechanism linking OSA with RH and stroke, whereas early morning sympathetic activation appears significantly important in the pathogenesis of refractory hypertension. Support (if any) This study was funded by Indian council of Medical Research, New Delhi, India.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".