Delsart Pascal, Takla Marc, Marboeuf Philippe, Claisse Gonzague, Kpogbemabou Natalia, Lubret Remy, Hattabi Medhi, Mounier-Vehier Claire
Service de médecine vasculaire et Hypertension artérielle, Hôpital Cardiologique, CHRU Lille, Boulevard Pr Leclercq, 59037, Lille Cedex, France,
High Blood Press Cardiovasc Prev. 2015 Jun;22(2):159-64. doi: 10.1007/s40292-015-0088-1. Epub 2015 Apr 17.
Obstructive sleep apnea (OSA) is the most common factor involved in uncontrolled blood pressure (BP). Management of OSA is part of cardiologist work. We have few data on BP control in a population of OSA followed by cardiologists.
We evaluated the prevalence of effective BP control using ambulatory measurement in a population of patients followed in cardiology.
Data from 69 OSA patients treated for more than 6 months by continuous positive airway pressure (CPAP) were collected prospectively from March 2012 until December 2012. These patients were divided into 2 groups according to the results of 24-h ambulatory BP monitoring (ABPM). Controlled BP was defined as a 24 h BP <130/80 mmHg.
All patients were hypertensive. 44 patients (63 %) had uncontrolled hypertension (HTN). The onset of OSA (p = 0.01) and persistent daytime sleepiness appeared as predictors of uncontrolled BP. Systolic BP (SBP) during consultation and all the ABPM variables were higher in uncontrolled BP patients. Uncontrolled BP was associated with greater left ventricular mass (p = 0.02) and greater diameter of the ascending aorta (p = 0.04).
Control of HTN should be evaluated in all OSA patients, using ABPM. The onset of OSA and high SBP during consultation are both factors associated with uncontrolled BP in this population. Repeating ABPM should be of interest for the follow up of these patients.
阻塞性睡眠呼吸暂停(OSA)是血压控制不佳最常见的因素。OSA的管理是心脏病专家工作的一部分。关于心脏病专家随访的OSA患者人群的血压控制,我们掌握的数据较少。
我们使用动态测量评估心脏病科随访患者人群中有效血压控制的患病率。
前瞻性收集2012年3月至2012年12月期间69例接受持续气道正压通气(CPAP)治疗超过6个月的OSA患者的数据。根据24小时动态血压监测(ABPM)结果将这些患者分为2组。血压控制良好定义为24小时血压<130/80 mmHg。
所有患者均患有高血压。44例患者(63%)存在高血压控制不佳的情况。OSA的发病(p = 0.01)和持续的日间嗜睡表现为血压控制不佳的预测因素。血压控制不佳的患者在会诊时的收缩压(SBP)以及所有ABPM变量均较高。血压控制不佳与更大的左心室质量(p = 0.02)和升主动脉更大的直径(p = 0.04)相关。
应使用ABPM对所有OSA患者的高血压控制情况进行评估。在该人群中,OSA的发病和会诊时的高SBP均是与血压控制不佳相关的因素。重复进行ABPM对这些患者的随访可能有意义。