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阻塞性睡眠呼吸暂停不会损害高血压老年患者进行直至力竭的渐进性运动的心肺反应。

Obstructive sleep apnea does not impair cardiorespiratory responses to progressive exercise performed until exhaustion in hypertensive elderly.

机构信息

Laboratory of Physical Training Studies Applied to Health, Physical Education Department, Universidade Federal da Paraíba (UFPB), João Pessoa, PB, Brazil.

Associate Graduate Program in Physical Education UPE/UFPB, João Pessoa, Brazil.

出版信息

Sleep Breath. 2018 May;22(2):431-437. doi: 10.1007/s11325-017-1557-7. Epub 2017 Aug 24.

Abstract

BACKGROUND

Elderly people have a high prevalence to systemic arterial hypertension (SAH) and obstructive sleep apnea (OSA). Both comorbidities are closely associated and inflict damage on cardiorespiratory capacity.

METHODS

In order to assess cardiorespiratory responses to the cardiopulmonary exercise test (CPET) among hypertensive elderly with OSA, we enrolled 28 subjects into two different groups: without OSA (No-OSA: apnea/hypopnea index (AHI) < 5 events/h; n = 15) and with OSA (OSA: AHI ≥ 15 events/h; n = 13). All subjects underwent CPET and polysomnographic assessments. After normality and homogeneity evaluations, independent t test and Pearson's correlation were performed. The significance level employed was p ≤ 0.05.

RESULTS

Hypertensive elderly with OSA presented lower heart rate recovery (HRR) in the second minute (HRR) in relation to the No-OSA group. A negative correlation between AHI and ventilation (VE) (r = -0.63, p = 0.02) was found in polysomnography and CPET data comparisons, and oxygen saturation (OS) levels significantly correlated with VE/VCO (r = 0.66, p = 0.01); in addition, OSA group presented a positive correlation between oxygen consumption and OS (r = 0.60, p = 0.02), unlike the no-OSA group.

CONCLUSIONS

OSA does not affect the CPET variables in hypertensive elderly, but it attenuates the HRR. The association between OS during sleep with ventilatory responses probably occurs due to the adaptations in the oxygen transport system unleashed via mechanical respiratory feedback; thus, it has been identified that OSA compromises the oxygen supply in hypertensive elderly.

摘要

背景

老年人中系统性动脉高血压(SAH)和阻塞性睡眠呼吸暂停(OSA)的患病率很高。这两种合并症密切相关,都会对心肺功能造成损害。

方法

为了评估患有 OSA 的老年高血压患者对心肺运动测试(CPET)的心肺反应,我们将 28 名受试者分为两组:无 OSA(No-OSA:呼吸暂停/低通气指数(AHI)<5 次/小时;n=15)和 OSA(OSA:AHI≥15 次/小时;n=13)。所有受试者均接受 CPET 和多导睡眠图评估。在进行正态性和同质性评估后,进行独立 t 检验和 Pearson 相关性分析。采用的显著性水平为 p≤0.05。

结果

与 No-OSA 组相比,患有 OSA 的老年高血压患者在第 2 分钟(HRR)时的心率恢复(HRR)较低。在多导睡眠图和 CPET 数据比较中,发现 AHI 与通气(VE)呈负相关(r=-0.63,p=0.02),而氧饱和度(OS)水平与 VE/VCO 显著相关(r=0.66,p=0.01);此外,OSA 组的耗氧量与 OS 呈正相关(r=0.60,p=0.02),而 No-OSA 组则无此相关性。

结论

OSA 不影响高血压老年患者的 CPET 变量,但会减弱 HRR。睡眠期间 OS 与通气反应之间的关联可能是由于机械呼吸反馈释放的氧气输送系统的适应所致;因此,已经确定 OSA 会损害高血压老年患者的氧气供应。

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