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[一项关于睡眠呼吸暂停与高血压患病率之间关联的多中心研究]

[A multi-center study on the association between sleep apnea and prevalence of hypertension].

作者信息

Chen Bao-Yuan, He Quan-Ying

机构信息

Department of Respiratory Medicine, Tianjin Medical University General Hospital, Tianjin, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2007 Dec;30(12):894-7.

Abstract

OBJECTIVE

To investigate the prevalence of hypertension among sleep apnea patients and the associated factors.

METHODS

A total of 2297 patients (male 1310, female 211) from 20 teaching hospitals were enrolled in this study. Medical history interview, blood pressure measurement and an in-hospital polysomnogram were performed for all the patients. Questionnaires of sleep apnea and hypertension were finished by all the patients. SPSS 11.0 software package was used for data analyzing, and prevalence rates of hypertension were compared by chi-square test.

RESULTS

The prevalence of hypertension in the apnea hypopnea index (AHI) < 5/h group was 23.5%, but in AHI > or = 5/h group was 49.3%, the difference being significant. The prevalence of hypertension in the group with obstructive sleep apnea hypopnea syndrome (OSAHS) was 56.2%, but was 63.7% and 39.4% in the groups with and without hypertension family history, respectively. The odds ratio of hypertension in AHI > or = 5/h group was 3.167 times higher than in the AHI < 5/h group (OR = 3.167, 95% CI 2.953 - 5.426, P < 0.01). The prevalence of hypertension increased with AHI increases, and it was the highest in subjects with AHI of 16 - 20/h, but deceased slowly in subjects with AHI of 66 - 70/h. Two equations were formulated to show the relationship between AHI and the prevalence of hypertension: the prevalence of hypertension = 0.3199 + 0.0042 x AHI, and OR of the prevalence of hypertension = 1.018 + 0.017 x AHI. The AHI was an independent risk factor for the prevalence of hypertension after control for age, sex, BMI and family history of hypertension.

CONCLUSIONS

The prevalence of hypertension in subjects with sleep apnea was higher than those without sleep apnea. There was a close relationship between sleep apnea syndrome and the prevalence of hypertension. Sleep apnea was an independent factor for hypertension after control for the confounding factors.

摘要

目的

探讨睡眠呼吸暂停患者中高血压的患病率及其相关因素。

方法

本研究纳入了来自20家教学医院的2297例患者(男性1310例,女性211例)。对所有患者进行病史访谈、血压测量及院内多导睡眠图检查。所有患者均完成睡眠呼吸暂停和高血压问卷调查。采用SPSS 11.0软件包进行数据分析,通过卡方检验比较高血压患病率。

结果

呼吸暂停低通气指数(AHI)<5次/小时组的高血压患病率为23.5%,而AHI≥5次/小时组为49.3%,差异有统计学意义。阻塞性睡眠呼吸暂停低通气综合征(OSAHS)组的高血压患病率为56.2%,有高血压家族史组和无高血压家族史组分别为63.7%和39.4%。AHI≥5次/小时组高血压的比值比高于AHI<5次/小时组3.167倍(OR = 3.167,95%CI 2.9 – 5.426,P<0.01)。高血压患病率随AHI增加而升高,在AHI为16 - 20次/小时的受试者中最高,但在AHI为66 - 70次/小时的受试者中升高缓慢。建立了两个方程来表示AHI与高血压患病率之间的关系:高血压患病率=0.3199 + 0.0042×AHI,高血压患病率的OR = 1.018 + 0.017×AHI。在控制年龄、性别、BMI和高血压家族史后,AHI是高血压患病率的独立危险因素。

结论

睡眠呼吸暂停患者的高血压患病率高于无睡眠呼吸暂停者。睡眠呼吸暂停综合征与高血压患病率之间存在密切关系。在控制混杂因素后,睡眠呼吸暂停是高血压的独立因素。

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