The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region China, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang China, No. 91 Tianchi Road, Tianshan District, Urumqi, Xinjiang, 830001, China.
Sleep Breath. 2018 May;22(2):377-384. doi: 10.1007/s11325-017-1571-9. Epub 2017 Nov 17.
In this cross-sectional study, we analyzed the potential association between sleep measures and blood pressure variability.
Ninety-three middle-aged hypertensive males, who underwent polysomnography and 24-h ambulatory blood pressure monitoring, were enrolled. Blood pressure variability was assessed by blood pressure standard deviation. Obstructive sleep apnea (apnea hypopnea index ≥ 15) was diagnosed in 52 (55.91%) patients. Mean body mass index and age were 27.77 ± 3.11 kg/m and 44.05 ± 8.07 years, respectively.
Hypertensive males with obstructive sleep apnea showed significantly higher 24-h, diurnal, and nocturnal diastolic blood pressure variability, compared to those without obstructive sleep apnea. While total cohort was further divided into two groups using the median of oxygen desaturation index, another indicator for severity of OSA, significant differences were also observed in 24-h, diurnal, and nocturnal diastolic blood pressure variability between two groups with higher and lower oxygen desaturation index. While subjects were also divided into two groups via the mean of sleep stage 1, hypertensive males with sleep stage 1 ≥ 8.1% showed significantly higher diurnal diastolic blood pressure variability than those with sleep stage 1 < 8.1%. Apnea hypopnea index was independently associated with 24-h and nocturnal diastolic blood pressure variability; oxygen desaturation index of 3% with 24-h diastolic, diurnal, and nocturnal diastolic blood pressure; and sleep stage 1 was with 24-h and with diurnal diastolic blood pressure variability in all study subjects.
Effects of obstructive sleep apnea on blood pressure variability may not be limited nocturnally.
在这项横断面研究中，我们分析了睡眠指标与血压变异性之间的潜在关联。
共纳入 93 名中年高血压男性患者，他们接受了多导睡眠图和 24 小时动态血压监测。血压变异性通过血压标准差进行评估。诊断阻塞性睡眠呼吸暂停（呼吸暂停低通气指数≥15）的患者有 52 例（55.91%）。平均体重指数和年龄分别为 27.77±3.11kg/m 和 44.05±8.07 岁。
与无阻塞性睡眠呼吸暂停的患者相比，患有阻塞性睡眠呼吸暂停的高血压男性 24 小时、日间和夜间舒张压变异性显著更高。而当总队列进一步根据氧减饱和指数的中位数（另一个评估 OSA 严重程度的指标）分为两组时，两组间 24 小时、日间和夜间舒张压变异性也存在显著差异。当根据睡眠分期 1 的平均值将患者分为两组时，睡眠分期 1≥8.1%的高血压男性日间舒张压变异性显著高于睡眠分期 1<8.1%的患者。呼吸暂停低通气指数与 24 小时和夜间舒张压变异性独立相关；3%的氧减饱和指数与 24 小时舒张压、日间和夜间舒张压相关；而睡眠分期 1 与所有研究对象的 24 小时和日间舒张压变异性相关。
阻塞性睡眠呼吸暂停对血压变异性的影响可能不仅局限于夜间。
