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[瓜德罗普岛(法属西印度群岛)成年人阻塞性睡眠呼吸暂停与高血压及心血管风险的相关性]

[Hypertension and cardiovascular risk associated with obstructive sleep apnea in adult in Guadeloupe (French West Indies)].

作者信息

Billy Brissac R, Phiraï S, Larifla L, Atallah A, Hedreville M, Hedreville S, Fassih M, Cadelis G, Rhinan P, Hamony Soter V, Foucan L

机构信息

Unité d'explorations cardiovasculaires, pôle cardiovasculaire, CHU de Pointe-à-Pitre, BP 465, 97159 Pointe-à-Pitre cedex, Guadeloupe.

Laboratoire du sommeil, 97139 Les Abymes, Guadeloupe.

出版信息

Ann Cardiol Angeiol (Paris). 2015 Jun;64(3):132-8. doi: 10.1016/j.ancard.2015.04.010. Epub 2015 Jun 3.

Abstract

BACKGROUND AND PURPOSE

In Guadeloupe, data on the relationships between arterial hypertension and obstructive sleep apnea are unavailable. The aim of this study was: to assess the frequency of hypertension and non-dipper pattern evaluated by 48-hour ambulatory blood pressure monitoring in an adult population identified obstructive sleep apnea/non-obstructive sleep apnea during overnight polygraphy ; to determine the cardio-metabolic factors associated with obstructive sleep apnea.

DESIGN AND METHOD

A cross-sectional study was realized at Pointe-à-Pitre Hospital. Patients were referred for suspected sleep apnea to sleep specialist and performed a nocturnal polygraphy. Diagnosis was confirmed if the apnea-hypopnea index was ≥ 5. We obtained two groups: sleep apnea/non-sleep apnea. All patients underwent 48-hour ambulatory blood pressure monitoring. The cardio-metabolic factors were identified and assessed (fasten level of hs-CRP and Homa-IR index).

RESULTS

A total of 204 patients were included. Mean age at diagnosis was 54 ± 10 years, 63% were women. OSA was present in 69.6% with a higher frequency in men than in women. Difference was not significant between the two groups for hypertension frequency (84.5% vs 77%; P=0.22), non-dipper pattern (77.5% vs 76%; P=0.79) and hs-CRP. Differences for age, snoring, body max index, mean waist circumference, Homa-IR index, obesity, dyslipidemia, and type 2 diabetes were significant.

CONCLUSIONS

Our data highlight raised frequency of cardiovascular metabolic factors in patients with obstructive sleep apnea and confirm their high cardiovascular risk.

摘要

背景与目的

在瓜德罗普岛,关于动脉高血压与阻塞性睡眠呼吸暂停之间关系的数据尚不可得。本研究的目的是:评估在通过夜间多导睡眠监测确定为阻塞性睡眠呼吸暂停/非阻塞性睡眠呼吸暂停的成年人群中,经48小时动态血压监测评估的高血压和非勺型血压模式的频率;确定与阻塞性睡眠呼吸暂停相关的心脏代谢因素。

设计与方法

在皮特尔角城医院开展了一项横断面研究。因疑似睡眠呼吸暂停而被转诊至睡眠专科医生处的患者接受了夜间多导睡眠监测。如果呼吸暂停低通气指数≥5,则确诊。我们获得了两组:睡眠呼吸暂停组/非睡眠呼吸暂停组。所有患者均接受了48小时动态血压监测。确定并评估了心脏代谢因素(hs-CRP的空腹水平和Homa-IR指数)。

结果

共纳入204例患者。诊断时的平均年龄为54±10岁,63%为女性。69.6%的患者存在阻塞性睡眠呼吸暂停,男性的发生率高于女性。两组在高血压频率(84.5%对77%;P=0.22)、非勺型血压模式(77.5%对76%;P=0.79)和hs-CRP方面的差异不显著。在年龄、打鼾、体重指数、平均腰围、Homa-IR指数、肥胖、血脂异常和2型糖尿病方面的差异显著。

结论

我们的数据突出了阻塞性睡眠呼吸暂停患者中心脏血管代谢因素的发生率升高,并证实了他们较高的心血管风险。

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