Chin Kazuo, Nakamura Takaya, Takahashi Ken-ichi, Sumi Kensuke, Matsumoto Hisako, Niimi Akio, Fukuhara Shunichi, Mishima Michiaki, Nakamura Takashi
Department of Physical Therapeutics, Kyoto University Hospital, Kyoto, Japan.
J Hypertens. 2006 Oct;24(10):2091-9. doi: 10.1097/01.hjh.0000244960.69985.4c.
Effective treatment of obstructive sleep apnoea (OSA) with nasal continuous positive airway pressure (nCPAP) lowers blood pressure (BP). The long-term effects of nCPAP treatment on BP in OSA patients are not well known. The time period of such treatment sufficient to lower BP in OSA patients is also not known. We investigated compliance with long-term nCPAP therapy and its effects on BP.
This observational study involved 66 OSA patients [59 men, seven women; mean age, 51 (48-54) years; body mass index (BMI), 28.7 (27.7-29.7) kg/m; apnoea and hypopnoea, 50.3 (45.6-55.0)/h; 95% confidence intervals]. BP and BMI were measured before the study and at two checkpoints after usage of nCPAP [620 (552-688) and 1071 (1000-1143) days].
The different times between the first and second checkpoints for detecting objective compliance were 17 (4-30) min (P = 0.003). Diastolic BP decreased by 5.9 (3.1-8.7) mmHg after 600 days nCPAP treatment and by 4.6 (2.0-7.2) mmHg after 1000 days (P = 0.0006). Systolic BP and BMI did not change significantly. Usage of nCPAP treatment for a daily average of 3 h was needed to achieve a significant decrease in diastolic BP [7.4 (4.3-10.6) mmHg, P < 0.0001]. Diastolic BP of normotensive OSA patients did not change significantly by nCPAP treatment, but that of hypertensive OSA patients decreased significantly within 1 month-3 years of nCPAP treatment whether or not medication was used.
In patients with severe OSA, the use of nCPAP for a daily average of 3 h would be sufficient to decrease the diastolic BP of hypertensive OSA patients.
采用经鼻持续气道正压通气（nCPAP）有效治疗阻塞性睡眠呼吸暂停（OSA）可降低血压（BP）。nCPAP治疗对OSA患者血压的长期影响尚不清楚。使OSA患者血压降低所需的该治疗时间段也未知。我们调查了长期nCPAP治疗的依从性及其对血压的影响。
这项观察性研究纳入了66例OSA患者[59例男性，7例女性；平均年龄51（48 - 54）岁；体重指数（BMI）28.7（27.7 - 29.7）kg/m²；呼吸暂停及低通气次数50.3（45.6 - 55.0）次/小时；95%置信区间]。在研究前以及使用nCPAP后的两个检查点[620（552 - 688）天和1071（1000 - 1143）天]测量血压和BMI。
检测客观依从性的第一个和第二个检查点之间的不同时间为17（4 - 30）分钟（P = 0.003）。nCPAP治疗600天后舒张压降低5.9（3.1 - 8.7）mmHg，1000天后降低4.6（2.0 - 7.2）mmHg（P = 0.0006）。收缩压和BMI无显著变化。平均每日使用nCPAP治疗3小时才能使舒张压显著降低[7.4（4.3 - 10.6）mmHg，P < 0.0001]。血压正常的OSA患者经nCPAP治疗后舒张压无显著变化，但无论是否使用药物，高血压OSA患者在nCPAP治疗1个月至3年内舒张压显著降低。
在重度OSA患者中，平均每日使用nCPAP 3小时足以降低高血压OSA患者的舒张压。
