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基层医疗环境中的难治性高血压与阻塞性睡眠呼吸暂停

Resistant hypertension and obstructive sleep apnea in the primary-care setting.

作者信息

Demede M, Pandey A, Zizi F, Bachmann R, Donat M, McFarlane S I, Jean-Louis G, Ogedegbe G

机构信息

Brooklyn Center for Health Disparities, Department of Medicine, SUNY Downstate Medical Center, 450 Clarkson Avenue, P.O. Box 1199, Brooklyn, NY 11203-2098, USA.

出版信息

Int J Hypertens. 2011;2011:340929. doi: 10.4061/2011/340929. Epub 2011 Jun 8.

Abstract

We ascertained the prevalence of resistant hypertension (RH) among blacks and determined whether RH patients are at greater risk for obstructive sleep apnea (OSA) than hypertensives. Method. Data emanated from Metabolic Syndrome Outcome Study (MetSO), a study investigating metabolic syndrome among blacks in the primary-care setting. Sample of 200 patients (mean age = 63 ± 13 years; female = 61%) with a diagnosis of hypertension provided subjective and clinical data. RH was defined using the JNC 7and European Society guidelines. We assessed OSA risk using the Apnea Risk Evaluation System ARES), defining high risk as a total ARES score ≥6. Results. Overall, 26% met criteria for RH and 40% were at high OSA risk. Logistic regression analysis, adjusting for effects of age, gender, and medical co morbidities, showed that patients with RH were nearly 2.5 times more likely to be at high OSA risk, relative to those with hypertension (OR = 2.46, 95% CI: 1.03-5.88, P < .05). Conclusion. Our findings show that the prevalence of RH among blacks fell within the range of RH for the general hypertensive population (3-29%). However, patients with RH were at significantly greater risk of OSA compared to patients with hypertension.

摘要

我们确定了黑人中难治性高血压(RH)的患病率,并确定了RH患者是否比高血压患者患阻塞性睡眠呼吸暂停(OSA)的风险更高。方法。数据来自代谢综合征结局研究(MetSO),这是一项在初级保健环境中调查黑人代谢综合征的研究。200例诊断为高血压的患者(平均年龄 = 63 ± 13岁;女性 = 61%)提供了主观和临床数据。RH采用美国国家联合委员会第7版和欧洲学会指南进行定义。我们使用呼吸暂停风险评估系统(ARES)评估OSA风险,将高风险定义为ARES总分≥6分。结果。总体而言,26%符合RH标准,40%处于高OSA风险。在对年龄、性别和合并症的影响进行校正的逻辑回归分析中,相对于高血压患者,RH患者处于高OSA风险的可能性几乎高出2.5倍(OR = 2.46,95%CI:1.03 - 5.88,P < .05)。结论。我们的研究结果表明,黑人中RH的患病率处于一般高血压人群RH患病率范围(3% - 29%)内。然而,与高血压患者相比,RH患者患OSA的风险显著更高。

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