Hospital Universitário de Brasília, Universidade de Brasília, Brasília, DF, Brazil.
Arq Bras Cardiol. 2009 Sep;93(3):275-82. doi: 10.1590/s0066-782x2009000900012.
Sleep hypoxemia may change blood pressure by sympathetic activation. Few studies have analyzed blood pressure parameters in COPD patients who do not present sleep apnea, but do present sleep desaturation.
To analyze blood pressure parameters in COPD patients with sleep desaturation not caused by apnea.
Thirteen patients with COPD underwent spirometry, blood gas, polysomnography and ABPM for blood pressure evaluation. Fourteen patients without COPD underwent spirometry, oximetry and ABPM. Blood pressure analyses were carried out both during wakefulness and sleep. Both groups were comprised of patients with no history of hypertension.
The two groups were similar as regards age, height, weight, and body mass index. A significant difference (p<0.05) was found between blood pressure levels during the wakefulness, sleep, 24-hour and sleep dip periods. Higher blood pressure levels were observed in patients with COPD, except for diastolic levels during wakefulness and maximum values during sleep and in the 24 hours. Sleep dip in the COPD group was attenuated, whereas physiological dip was observed in the control group, with lower blood pressure levels.
Systolic and diastolic blood pressure levels in the COPD group were higher than those of the control group, with a significant difference found for all periods studied, except for diastolic levels during wakefulness and in the 24 hours. We can conclude that the group of COPD patients with sleep desaturation has significantly higher blood pressure levels than the control group.
睡眠低氧血症可能通过交感神经激活改变血压。很少有研究分析过不伴睡眠呼吸暂停但存在睡眠低氧血症的 COPD 患者的血压参数。
分析无睡眠呼吸暂停但存在睡眠低氧血症的 COPD 患者的血压参数。
13 名 COPD 患者接受了肺功能检查、血气分析、多导睡眠图和 ABPM 以评估血压。14 名无 COPD 的患者接受了肺功能检查、血氧饱和度监测和 ABPM。血压分析在清醒和睡眠期间进行。两组均由无高血压病史的患者组成。
两组在年龄、身高、体重和体重指数方面相似。在清醒、睡眠、24 小时和睡眠低谷期,两组的血压水平存在显著差异(p<0.05)。COPD 患者的血压水平较高,除了清醒时的舒张压和睡眠时的最大舒张压和 24 小时的舒张压。COPD 组的睡眠低谷期减弱,而对照组出现生理性低谷期,血压水平较低。
COPD 组的收缩压和舒张压水平高于对照组,除了清醒时和 24 小时的舒张压外,所有研究期间的差异均有统计学意义。我们可以得出结论,存在睡眠低氧血症的 COPD 患者组的血压水平明显高于对照组。