Stergiou George S, Triantafyllidou Evgenia, Cholidou Kyriaki, Kollias Anastasios, Destounis Antonios, Nasothimiou Efthimia G, Markozannes Evaggelos, Alchanatis Manos
Third University Department of Medicine, Hypertension Center, Sotiria Hospital, Athens, Greece.
Blood Press Monit. 2013 Feb;18(1):21-6. doi: 10.1097/MBP.0b013e32835d3608.
Obstructive sleep apnea (OSA) is known to be related to nocturnal blood pressure (BP) and nondipping hypertension. This pilot study evaluated night-time BP assessed using a home monitor in patients with OSA.
Patients referred to a sleep clinic were subjected to polysomnography, clinic BP measurements, and home BP monitoring using a device that allows daytime (3 days, two duplicate readings per day) and automated night-time BP measurement (3 nights, three readings per night).
Thirty-nine patients were included [72% men, mean age 48.7±10.8 years, clinic BP 131.2±19.6/84.1±11.9 mmHg, apnea-hypopnea index (AHI): 35.2±25.7]. All BP measurements were significantly correlated with the polysomnography indices. There was a consistent trend toward stronger correlations of the night-time diastolic home BP with the AHI (r=0.56), the duration of desaturation (0.53), and the maximum (-0.57) and minimum (-0.48) arterial oxygen saturation (all P<0.001). In stepwise multivariate analysis (independent variables age, sex, body weight, smoking status, and BP parameters), the AHI was associated independently with weight and night-time diastolic home BP (R=0.53).
In patients with OSA, the assessment of night-time BP using a home monitor appears to be feasible and related to the severity of OSA. Given the wide availability of home BP monitoring in clinical practice, this method appears to be useful in the evaluation of BP in patients with OSA.
阻塞性睡眠呼吸暂停(OSA)已知与夜间血压(BP)及非勺型高血压有关。这项初步研究评估了使用家庭监测仪对OSA患者进行的夜间血压测量。
转诊至睡眠诊所的患者接受了多导睡眠监测、诊所血压测量以及使用一种可进行日间(3天,每天两次重复测量)和自动夜间血压测量(3晚,每晚三次测量)的设备进行家庭血压监测。
纳入了39名患者[男性占72%,平均年龄48.7±10.8岁,诊所血压131.2±19.6/84.1±11.9 mmHg,呼吸暂停低通气指数(AHI):35.2±25.7]。所有血压测量值均与多导睡眠监测指标显著相关。夜间舒张压家庭血压与AHI(r = 0.56)、去饱和持续时间(0.53)、最大(-0.57)和最小(-0.48)动脉血氧饱和度之间存在一致的更强相关性趋势(均P<0.001)。在逐步多变量分析(自变量为年龄、性别、体重、吸烟状况和血压参数)中,AHI独立与体重及夜间舒张压家庭血压相关(R = 0.53)。
对于OSA患者,使用家庭监测仪评估夜间血压似乎是可行的,且与OSA的严重程度相关。鉴于家庭血压监测在临床实践中广泛可用,这种方法似乎对评估OSA患者的血压很有用。