Department of Chest Diseases, Faculty of Medicine, Ankara University; Ankara-Turkey.
Anatol J Cardiol. 2020 Jun;23(6):334-341. doi: 10.14744/AnatolJCardiol.2020.71429.
Obstructive sleep apnea (OSA) is associated with elevated blood pressure (BP) and increases the risk of developing cardiovascular diseases. This study aimed to determine the clinical and polysomnographic features of OSA that are significantly associated with hypertension (HT).
This is a prospective study that enrolled patients diagnosed with OSA in Ankara University Faculty of Medicine from January 2015 to June 2016. The patients were categorized into normotensives (n=125) and hypertensives (n=141). BP was taken at the evening before and the morning after polysomnography (PSG). The polysomnographic findings of normotensive and hypertensive patients were compared, and independent risk factors that are associated with HT were analyzed.
Hypertensive patients exhibited older age and higher Epworth sleepiness scale (ESS), apnea-hypopnea index (AHI), mean apnea duration, arousal index, and oxygen desaturation index (ODI) than normotensive patients. Nocturnal oxygen desaturation (NOD) was more frequent and the percentage of the duration of NOD to total sleep time (TST) was higher in hypertensive than normotensive patients. Multivariate analyses revealed that age (OR: 1.095, 95% CI 1.053 to 1.139, p<0.001), ESS (OR: 1.186, 95% CI 1.071 to 1.313, p=0.001), mean apnea duration (OR: 1.072, 95% CI 1.032 to 1.113, p=0.002), ODI (OR: 1.062, 95% CI 1.025 to 1.101, p=0.001), and NOD (OR: 2.439, 95% CI 1.170 to 5.086, p=0.017) were independent risk factors for HT in OSA.
This study suggests that age, ESS, parameters of oxygenation, and apnea duration were associated with HT in patients with OSA. Hence, patients with OSA with these findings should be evaluated for HT. (Anatol J Cardiol 2020; 23: 334-41).
阻塞性睡眠呼吸暂停（OSA）与血压升高有关，并增加患心血管疾病的风险。本研究旨在确定与高血压（HT）显著相关的 OSA 的临床和多导睡眠图特征。
这是一项前瞻性研究，纳入了 2015 年 1 月至 2016 年 6 月在安卡拉大学医学院诊断为 OSA 的患者。患者分为正常血压组（n=125）和高血压组（n=141）。在多导睡眠图（PSG）前一天晚上和后一天早上测量血压。比较正常血压和高血压患者的多导睡眠图结果，并分析与 HT 相关的独立危险因素。
与正常血压患者相比，高血压患者的年龄更大，Epworth 嗜睡量表（ESS）、呼吸暂停-低通气指数（AHI）、平均呼吸暂停时间、觉醒指数和氧减饱和度指数（ODI）更高。与正常血压患者相比，高血压患者夜间氧减饱和度（NOD）更频繁，NOD 占总睡眠时间（TST）的百分比更高。多变量分析显示，年龄（OR：1.095，95%CI 1.053 至 1.139，p<0.001）、ESS（OR：1.186，95%CI 1.071 至 1.313，p=0.001）、平均呼吸暂停时间（OR：1.072，95%CI 1.032 至 1.113，p=0.002）、ODI（OR：1.062，95%CI 1.025 至 1.101，p=0.001）和 NOD（OR：2.439，95%CI 1.170 至 5.086，p=0.017）是 OSA 患者 HT 的独立危险因素。
本研究表明，年龄、ESS、氧合参数和呼吸暂停时间与 OSA 患者的 HT 相关。因此，患有 OSA 并具有这些发现的患者应评估 HT 的发生。
