Silverberg D S, Oksenberg A
Department of Nephrology, Tel Aviv Medical Center, Weizman 6, Tel Aviv 64239, Israel.
Curr Hypertens Rep. 2001 Jun;3(3):209-15. doi: 10.1007/s11906-001-0040-8.
About 50% of all patients with essential hypertension have obstructive sleep apnea (OSA), and another 40% of essential hypertension patients are habitual snorers, but without OSA. There is now convincing evidence that both OSA and habitual snoring are independent risk factors for essential hypertension, and that treatment of OSA will reduce the blood pressure. There is also some evidence that treatment of habitual snoring will also reduce the blood pressure. If this is the case, then we postulate a unifying hypothesis: that these two sleep-related breathing disorders (SRBD) (OSA and habitual snoring) are very common contributing factors to what is called "essential hypertension." The many epidemiologic, clinical, hematologic, biochemical, and physiologic findings seen in essential hypertension could also be due to the associated SRBD. A routine search for SRBD by asking a few simple questions of all patients (especially those with hypertension) and their bed partners could increase the number of patients detected and treated significantly. Successful treatment of SRBD would improve sleep quality and the associated excessive daytime sleepiness, and thus improve the quality of life. In addition, there is a good chance that the hypertension will improve as well.
约50%的原发性高血压患者患有阻塞性睡眠呼吸暂停(OSA),另有40%的原发性高血压患者是习惯性打鼾者,但没有OSA。现在有令人信服的证据表明,OSA和习惯性打鼾都是原发性高血压的独立危险因素,并且治疗OSA会降低血压。也有一些证据表明,治疗习惯性打鼾也会降低血压。如果是这样,那么我们提出一个统一的假设:这两种与睡眠相关的呼吸障碍(SRBD)(OSA和习惯性打鼾)是导致所谓“原发性高血压”的非常常见的促成因素。在原发性高血压中看到的许多流行病学、临床、血液学、生物化学和生理学发现也可能归因于相关的SRBD。通过向所有患者(尤其是高血压患者)及其同床伴侣询问几个简单问题来常规筛查SRBD,可能会显著增加被检测和治疗的患者数量。成功治疗SRBD将改善睡眠质量以及相关的日间过度嗜睡,从而提高生活质量。此外,高血压也很有可能得到改善。