Panza Gino S, Puri Shipra, Lin Ho-Sheng, Badr M Safwan, Mateika Jason H
John D. Dingell Veterans Affairs Medical Center, Detroit, Michigan; and.
Department of Physiology.
Am J Respir Crit Care Med. 2022 Apr 15;205(8):949-958. doi: 10.1164/rccm.202108-1808OC.
Daily exposure to mild intermittent hypoxia (MIH) may elicit beneficial cardiovascular outcomes. To determine the effect of 15 days of MIH and in-home continuous positive airway pressure treatment on blood pressure in participants with obstructive sleep apnea and hypertension. We administered MIH during wakefulness 5 days/week for 3 weeks. The protocol consisted of twelve 2-minute bouts of hypoxia interspersed with 2 minutes of normoxia. End-tidal carbon dioxide was maintained 2 mm Hg above baseline values throughout the protocol. Control participants were exposed to a sham protocol (i.e., compressed air). All participants were treated with continuous positive airway pressure over the 3-week period. Results are mean ± SD. Sixteen male participants completed the study (experimental = 10; control = 6). Systolic blood pressure at rest during wakefulness over 24 hours was reduced after 15 days of MIH (142.9 ± 8.6 vs. 132.0 ± 10.7 mm Hg; < 0.001), but not following the sham protocol (149.9 ± 8.6 vs. 149.7 ± 10.8 mm Hg; = 0.915). Thus, the reduction in blood pressure from baseline was greater in the experimental group compared with control (-10.91 ± 4.1 vs. -0.17 ± 3.6 mm Hg; = 0.003). Modifications in blood pressure were accompanied by increased parasympathetic and reduced sympathetic activity in the experimental group, as estimated by blood pressure and heart rate variability analysis. No detrimental neurocognitive and metabolic outcomes were evident following MIH. MIH elicits beneficial cardiovascular and autonomic outcomes in males with OSA and concurrent hypertension. Clinical trial registered with www.clinicaltrials.gov (NCT03736382).
每日暴露于轻度间歇性低氧（MIH）可能会产生有益的心血管结果。为了确定15天的MIH和家庭持续气道正压通气治疗对阻塞性睡眠呼吸暂停和高血压参与者血压的影响。我们在清醒状态下每周5天给予MIH，持续3周。方案包括十二次2分钟的低氧发作，其间穿插2分钟的常氧。在整个方案中，呼气末二氧化碳维持在比基线值高2 mmHg。对照组参与者接受假方案（即压缩空气）。所有参与者在3周期间均接受持续气道正压通气治疗。结果为平均值±标准差。16名男性参与者完成了研究（实验组=10；对照组=6）。MIH 15天后，清醒状态下24小时静息收缩压降低（142.9±8.6 vs. 132.0±10.7 mmHg；P<0.001），但假方案后未降低（149.9±8.6 vs. 149.7±10.8 mmHg；P=0.915）。因此，与对照组相比，实验组血压从基线的降低幅度更大（-10.91±4.1 vs. -0.17±3.6 mmHg；P=0.003）。根据血压和心率变异性分析估计，实验组血压的改变伴随着副交感神经活动增加和交感神经活动减少。MIH后未出现有害的神经认知和代谢结果。MIH对患有阻塞性睡眠呼吸暂停和并发高血压的男性产生有益的心血管和自主神经结果。在www.clinicaltrials.gov上注册的临床试验（NCT03736382）。
