Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, College of Medicine & Public Health, Bedford Park, Australia.
Sleep Health Service, Respiratory and Sleep Services, Southern Adelaide Local Health Network (SAHLN), Mark Oliphant Building, Bedford Park, Australia.
Am J Hypertens. 2018 Jul 16;31(8):857-864. doi: 10.1093/ajh/hpy082.
There is mounting evidence for an association between sleep disorders and hypertension. In obstructive sleep apnea (OSA), there are plausible biological reasons for the development of hypertension, and treatment of OSA results in modest (2-3 mm Hg), adherence-dependent decreases in blood pressure, with larger effects evident in those with resistant hypertension. However, prospective, population-based cohort studies have not yet convincingly demonstrated a link between OSA and incident hypertension, and adequately powered controlled trials of CPAP for the prevention or treatment or hypertension are lacking. While associations have been identified between short sleep duration, insomnia, restless legs syndrome (RLS), shift work, and hypertension, the causative role of these conditions/circumstances is not proven, and further well-designed pathophysiological and/or interventional studies are needed. Particular emphasis should be placed on defining subgroups of hypertensive OSA patients that stand to benefit most from OSA treatment and in understanding the link between sleep apnea and hypertensive disorders of pregnancy. Well-controlled intervention studies are needed in populations with short sleep duration, insomnia, shift work sleep disorder, and RLS to confirm their putative links with hypertension.
越来越多的证据表明睡眠障碍与高血压之间存在关联。在阻塞性睡眠呼吸暂停（OSA）中，高血压的发展有合理的生物学原因，治疗 OSA 可导致血压适度（2-3mmHg）下降，且在抵抗性高血压患者中效果更为明显。然而，前瞻性、基于人群的队列研究尚未令人信服地证明 OSA 与新发高血压之间存在关联，并且缺乏针对 CPAP 预防或治疗高血压的充分有效的对照试验。虽然已经确定了睡眠时间短、失眠、不宁腿综合征（RLS）、轮班工作与高血压之间的关联，但这些情况/情况的因果作用尚未得到证实，需要进一步进行精心设计的病理生理学和/或干预研究。应特别重视确定最有可能从 OSA 治疗中获益的高血压 OSA 患者亚组，并了解睡眠呼吸暂停与妊娠高血压之间的联系。需要在睡眠时间短、失眠、轮班工作睡眠障碍和 RLS 的人群中进行良好对照的干预研究，以确认它们与高血压之间的潜在联系。
