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[阻塞性睡眠呼吸暂停综合征中的高血压]

[Hypertension during obstructive sleep apnea syndrome].

作者信息

Baguet Jean-Philippe

出版信息

Rev Prat. 2015 Jun;65(6):830-3.

Abstract

Hypertension (HT) related to obstructive sleep apnea syndrome (OSAS) is one of the secondary forms of HT. It must be systematically evoked in hypertensive patient because the association "obesity, major snoring and excessive diurnal sleepiness" is fickle during OSAS. HT in apneic patient is more often diastolic, nocturnal, with a non-dipper profile. Moreover, OSAS is very frequently present during resistant hypertension. There are many mechanisms linking OSAS to HT. The main stimulus is intermittent hypoxia and the most important pathophysiological consequence is high sympathetic activity. After doing the diagnosis of OSAS, its treatment principally associated lifestyle changes with continuous positive airway pressure (CPAP). CPAP can significantly decrease blood pressure, especially if compliance to treatment is good and hypertension is resistant.

摘要

与阻塞性睡眠呼吸暂停综合征(OSAS)相关的高血压(HT)是HT的继发性形式之一。在高血压患者中必须系统地考虑到这种情况,因为在OSAS期间,“肥胖、严重打鼾和日间过度嗜睡”之间的关联并不稳定。呼吸暂停患者的HT更常表现为舒张期、夜间性,且呈非勺型血压模式。此外,难治性高血压患者中OSAS非常常见。有许多机制将OSAS与HT联系起来。主要刺激因素是间歇性缺氧,最重要的病理生理后果是高交感神经活性。在诊断出OSAS后,其治疗主要包括生活方式改变和持续气道正压通气(CPAP)。CPAP可显著降低血压,尤其是在治疗依从性良好且高血压难治的情况下。

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