Wang Yan, Li Caili, Feng Liting, Feng Jing, Cao Jie, Chen Baoyuan
Respiratory Department, Tianjin Medical University General Hospital, Tianjin, China.
Graduate School, Tianjin Medical University, Tianjin, China.
J Int Med Res. 2014 Jun;42(3):773-80. doi: 10.1177/0300060513516756. Epub 2014 Mar 20.
To investigate the prevalence of hypertension and circadian blood pressure (BP) variations in patients with obstructive sleep apnoea-hypopnoea syndrome (OSAHS).
Patients referred to a sleep clinic underwent polysomnography with measurement of BP at four time points. They were classified into four groups (control, and mild, moderate or severe sleep apnoea) using the apnoea-hypopnoea index (AHI). Circadian variation was assessed using night-time to daytime mean BP (R(N/D)) and morning to evening mean BP (R(M/E)) ratios.
Hypertension was significantly more common in patients with OSAHS (50.5%) than in controls (30.4%). AHI was positively correlated with hypertension after controlling for related confounders. Mean BP values at all four time points rose with increasing AHI. The increase in night-time and morning values was more pronounced than the increase in daytime and evening values in patients with OSAHS, resulting in loss of the normal BP diurnal rhythm. The R(N/D) and R(M/E) ratios increased with increasing AHI. Daytime BP was significantly correlated with AHI and the lowest oxygen saturation value.
OSAHS was shown to be an independent risk factor for hypertension. It was also associated with loss of the normal BP diurnal rhythm.
探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者高血压的患病率及昼夜血压变化情况。
转诊至睡眠诊所的患者接受多导睡眠监测，并在四个时间点测量血压。使用呼吸暂停低通气指数（AHI）将他们分为四组（对照组、轻度、中度或重度睡眠呼吸暂停组）。使用夜间与白天平均血压（R(N/D)）和早晨与傍晚平均血压（R(M/E)）比值评估昼夜变化。
OSAHS患者中高血压的发生率（50.5%）显著高于对照组（30.4%）。在控制相关混杂因素后，AHI与高血压呈正相关。随着AHI增加，所有四个时间点的平均血压值均升高。OSAHS患者夜间和早晨血压值的升高比白天和傍晚血压值的升高更明显，导致正常血压昼夜节律消失。R(N/D)和R(M/E)比值随AHI增加而升高。白天血压与AHI及最低血氧饱和度值显著相关。
OSAHS被证明是高血压的独立危险因素。它还与正常血压昼夜节律消失有关。
