Department of Internal Medicine III, University Hospital Homburg University of the Saarland, Homburg/Saar, Germany.
Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany.
J Clin Hypertens (Greenwich). 2018 Mar;20(3):575-581. doi: 10.1111/jch.13202. Epub 2018 Jan 16.
Sleep disordered breathing (SDB) is highly prevalent in patients with high blood pressure (BP). Severity of SDB can be evaluated by the number of apneas and hypopneas per hour (AHI) or by measures of hypoxia. The objective of this study was to assess the association between different measures of SDB and BP. In 134 consecutive patients, polygraphy was performed to determine the AHI. Pulse oximetry was used to determine hypoxemic burden (time below 90% oxygen saturation [T90] and hypoxia load [HL], representing the integrated area above the curve of desaturation). AHI did not correlate with systolic and diastolic BP or pulse pressure. In contrast, HL correlated with pulse pressure during the day (P = .01) and night (P = .0034) before and after adjustment for body mass index. The correlation between systolic BP and HL at night disappeared following adjustment for body mass index. This study generates the hypothesis that nocturnal hypoxemic burden may represent a suitable marker of BP pattern and a potential treatment target in hypertensive patients.
睡眠呼吸障碍(SDB)在高血压(BP)患者中非常普遍。SDB 的严重程度可以通过每小时的呼吸暂停和低通气次数(AHI)或缺氧程度来评估。本研究的目的是评估 SDB 的不同测量指标与 BP 之间的关系。在 134 例连续患者中,进行了多导睡眠图以确定 AHI。脉搏血氧仪用于确定低氧血症负担(T90 和 HL,代表饱和度低于 90%的时间和去饱和曲线上方的积分区域)。AHI 与收缩压和舒张压或脉压均无相关性。相反,HL 与白天(P =.01)和夜间(P =.0034)的脉压相关,调整体重指数后仍具有相关性。调整体重指数后,夜间收缩压与 HL 之间的相关性消失。本研究提出假设,即夜间低氧血症负担可能是 BP 模式的合适标志物,也是高血压患者的潜在治疗靶点。