Dopp John M, Reichmuth Kevin J, Morgan Barbara J
Department of Orthopedics and Rehabilitation, Madison, WI 53706, USA.
Curr Hypertens Rep. 2007 Dec;9(6):529-34. doi: 10.1007/s11906-007-0095-2.
Obstructive sleep apnea (OSA) is a recognized cause of secondary hypertension. OSA episodes produce surges in systolic and diastolic pressure that keep mean blood pressure levels elevated at night. In many patients, blood pressure remains elevated during the daytime, when breathing is normal. Contributors to this diurnal pattern of hypertension include sympathetic nervous system overactivity and alterations in vascular function and structure caused by oxidant stress and inflammation. Treatment of OSA with nasal continuous positive airway pressure (CPAP) abolishes apneas, thereby preventing intermittent arterial pressure surges and restoring the nocturnal "dipping" pattern. CPAP treatment also has modest beneficial effects on daytime blood pressure. Because even small decreases in arterial pressure can contribute to reducing cardiovascular risk, screening for OSA is an essential element of evaluating patients with hypertension.
阻塞性睡眠呼吸暂停（OSA）是继发性高血压的一个公认病因。OSA发作会导致收缩压和舒张压急剧升高，使夜间平均血压水平持续升高。在许多患者中，白天呼吸正常时血压仍会升高。这种高血压昼夜模式的促成因素包括交感神经系统过度活跃以及氧化应激和炎症引起的血管功能和结构改变。使用鼻持续气道正压通气（CPAP）治疗OSA可消除呼吸暂停，从而防止间歇性动脉压急剧升高，并恢复夜间的“血压下降”模式。CPAP治疗对白天血压也有一定的有益作用。由于即使动脉压有小幅下降也有助于降低心血管风险，因此对OSA进行筛查是评估高血压患者的一个重要环节。
