Grotz Wolfgang, Büchner Nikolaus, Wessendorf Thomas, Teschler Helmut, Grote Ludger, Becker Heinrich F, Rump Lars Christian
Klinik für Innere Medizin II, Alfried Krupp Krankenhaus Essen, Essen, Germany.
Med Klin (Munich). 2006 Nov 15;101(11):880-5. doi: 10.1007/s00063-006-1117-6.
Obstructive sleep apnea and arterial hypertension are frequent diseases, but they are also often overlooked. There is a causal relationship of sleep apnea and hypertension. Undiagnosed sleep apnea is probably the most important reason for "essential" hypertension. It is important to identify these patients. All hypertensive patients should be asked for snoring, breathing arrest and daytime sleepiness, neck circumference should be measured, and an ambulant sleep apnea monitoring should be performed, if necessary. Especially patients with refractory hypertension or non-dippers should be screened for sleep apnea and patients with sleep apnea should be examined for arterial hypertension. Continuous positive airway pressure (CPAP) can effectively lower blood pressure in the hypertensive sleep apnea patient. This is especially true for the obstructive sleep apnea patient with refractory hypertension. CPAP therapy is probably the best therapy for sleep apnea-induced nocturnal blood pressure rises.
阻塞性睡眠呼吸暂停和动脉高血压是常见疾病，但它们也常常被忽视。睡眠呼吸暂停与高血压之间存在因果关系。未被诊断出的睡眠呼吸暂停可能是“原发性”高血压最重要的原因。识别这些患者很重要。应询问所有高血压患者是否打鼾、呼吸暂停和白天嗜睡，测量其颈围，必要时进行便携式睡眠呼吸暂停监测。尤其应筛查难治性高血压患者或非勺型血压患者是否存在睡眠呼吸暂停，而对于睡眠呼吸暂停患者，则应检查是否患有动脉高血压。持续气道正压通气（CPAP）可有效降低高血压睡眠呼吸暂停患者的血压。对于患有难治性高血压的阻塞性睡眠呼吸暂停患者而言尤其如此。CPAP治疗可能是治疗睡眠呼吸暂停引起的夜间血压升高的最佳疗法。
