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持续气道正压通气对睡眠呼吸暂停妇女血压和代谢特征的影响。

Effect of continuous positive airway pressure on blood pressure and metabolic profile in women with sleep apnoea.

机构信息

Respiratory Dept, Hospital Universitario de Valme, Sevilla, Spain

Respiratory Dept, Hospital Universitario Marques de Valdecilla, Santander, Spain.

出版信息

Eur Respir J. 2017 Aug 10;50(2). doi: 10.1183/13993003.00257-2017. Print 2017 Aug.

Abstract

Continuous positive airway pressure (CPAP) reduces blood pressure levels in hypertensive patients with obstructive sleep apnoea (OSA). However, the role of CPAP in blood pressure and the metabolic profile in women has not yet been assessed. In this study we investigated the effect of CPAP on blood pressure levels and the glucose and lipid profile in women with moderate-to-severe OSA.A multicentre, open-label, randomised controlled trial was conducted in 307 women diagnosed with moderate-to-severe OSA (apnoea-hypopnoea index ≥15 events·h) in 19 Spanish Sleep Units. Women were randomised to CPAP (n=151) or conservative treatment (n=156) for 12 weeks. Changes in office blood pressure measures as well as in the glucose and lipid profile were assessed in both groups.Compared with the control group, the CPAP group achieved a significantly greater decrease in diastolic blood pressure (-2.04 mmHg, 95% CI -4.02- -0.05; p=0.045), and a nonsignificantly greater decrease in systolic blood pressure (-1.54 mmHg, 95% CI -4.58-1.51; p=0.32) and mean blood pressure (-1.90 mmHg, 95% CI -4.0-0.31; p=0.084). CPAP therapy did not change any of the metabolic variables assessed.In women with moderate-to-severe OSA, 12 weeks of CPAP therapy improved blood pressure, especially diastolic blood pressure, but did not change the metabolic profile, compared with conservative treatment.

摘要

持续气道正压通气(CPAP)可降低阻塞性睡眠呼吸暂停(OSA)合并高血压患者的血压水平。然而,CPAP 对女性血压和代谢特征的作用尚未得到评估。本研究旨在探讨 CPAP 对中重度 OSA 女性血压水平和血糖、血脂谱的影响。

一项多中心、开放标签、随机对照试验纳入了 19 家西班牙睡眠中心的 307 名中重度 OSA(呼吸暂停低通气指数≥15 次·h)女性患者。患者被随机分配至 CPAP 组(n=151)或保守治疗组(n=156),治疗时间为 12 周。评估两组患者诊室血压测量值及血糖、血脂谱的变化。

与对照组相比,CPAP 组舒张压降低更明显(-2.04mmHg,95%CI-4.02 至-0.05;p=0.045),收缩压和平均血压降低也有统计学意义(-1.54mmHg,95%CI-4.58 至 1.51;p=0.32 和-1.90mmHg,95%CI-4.0 至 0.31;p=0.084)。CPAP 治疗并未改变任何代谢指标。

在中重度 OSA 女性患者中,与保守治疗相比,12 周 CPAP 治疗可改善血压,尤其是舒张压,但不改变代谢特征。

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