Tun Ye, Hida Wataru, Okabe Shinichi, Ogawa Hiromasa, Kikuchi Yoshihiro, Oikawa Manami, Kitamuro Tomomi, Kunio Shirato
First Department of Internal Medicine, Tohoku University School of Medicine, Sendai 980-8574, Japan.
Tohoku J Exp Med. 2003 Nov;201(3):181-90. doi: 10.1620/tjem.201.181.
Obstructive sleep apnea (OSA) is commonly associated with systemic hypertension and now recognized as an independent risk factor for daytime hypertension. We aimed to study the short- and long-term effect of nasal continuous positive airway pressure (CPAP) in hypertensive and normotensive patients with OSA. Forty-six patients with moderated to severe OSA were treated with nasal CPAP and followed after one year of treatment. Clinic blood pressure, heart rate, and body weight were taken before and followed up for one year after beginning nasal CPAP. In this study 25 patients with OSA were found to have hypertension (54.3%). The hypertensive group showed a significant reduction in clinic blood pressure after nasal CPAP, whereas the normotensive group showed no changes. The subgroup of hypertensive patients with OSA who had no anti-hypertensive medication revealed a decrease in clinic blood pressure comparable to those with anti-hypertensive drugs. The heart rate was not significantly changed in any patients. There was no significant correlation between the decrease in body weight and the reduction in blood pressure. These results suggest that nasal CPAP alone might have a substantial blood pressure lowering effect in hypertensive patients with OSA. This effect could decrease the morbidity and mortality related to cardiovascular complications in patients with OSA.
阻塞性睡眠呼吸暂停（OSA）通常与系统性高血压相关，现在被认为是日间高血压的一个独立危险因素。我们旨在研究鼻持续气道正压通气（CPAP）对OSA高血压患者和血压正常患者的短期和长期影响。46例中度至重度OSA患者接受鼻CPAP治疗，并在治疗一年后进行随访。在开始鼻CPAP治疗前及治疗一年后随访时测量临床血压、心率和体重。在本研究中，发现25例OSA患者患有高血压（54.3%）。高血压组在鼻CPAP治疗后临床血压显著降低，而血压正常组无变化。未服用抗高血压药物的OSA高血压患者亚组的临床血压下降程度与服用抗高血压药物的患者相当。所有患者的心率均无显著变化。体重下降与血压降低之间无显著相关性。这些结果表明，单独使用鼻CPAP可能对OSA高血压患者有显著的降压作用。这种作用可以降低OSA患者心血管并发症相关的发病率和死亡率。
