Lin Yi-Chih, Chen Chun-Tien, Chao Pin-Zhir, Chen Po-Yueh, Liu Wen-Te, Tsao Sheng-Teng, Lin Sheng-Feng, Bai Chyi-Huey
Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Front Surg. 2022 Mar 24;9:818591. doi: 10.3389/fsurg.2022.818591. eCollection 2022.
To determine whether treatment with uvulopalatopharyngoplasty (UPPP) or continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) prevents hypertension, compared to those not receiving any treatment.
A retrospective cohort study was conducted among 413 patients with OSA (age ≥ 35 years) at the Shuang Ho Hospital between 2009 and 2016. The patients were divided into three groups: UPPP, CPAP, and non-treatment groups. Data about the personal characteristics, history of comorbidities, and polysomnography (PSG) reports were collected at baseline. A Cox model with inverse probability of treatment weighting was used to adjust for confounders and baseline diversity.
After multivariate adjustment and weighting for incident hypertension, patients in both the CPAP and UPPP groups showed a significant preventive effect on hypertension than in the non-treatment group. Moreover, patients in the CPAP group had lower event rates than those in the UPPP group.
UPPP can prevent the development of new-onset hypertension in patients with OSA. CPAP had a better preventive effect than UPPP. UPPP might be a good alternative for reducing the risk of the onset of hypertension when compliance to CPAP is poor.
与未接受任何治疗的患者相比，确定阻塞性睡眠呼吸暂停（OSA）患者接受悬雍垂腭咽成形术（UPPP）或持续气道正压通气（CPAP）治疗是否能预防高血压。
2009年至2016年期间，在双和医院对413例年龄≥35岁的OSA患者进行了一项回顾性队列研究。患者分为三组：UPPP组、CPAP组和未治疗组。在基线时收集有关个人特征、合并症病史和多导睡眠图（PSG）报告的数据。使用具有治疗加权逆概率的Cox模型来调整混杂因素和基线差异。
在对新发高血压进行多变量调整和加权后，CPAP组和UPPP组患者对高血压的预防作用均显著优于未治疗组。此外，CPAP组患者的事件发生率低于UPPP组。
UPPP可预防OSA患者新发高血压的发生。CPAP的预防效果优于UPPP。当CPAP依从性较差时，UPPP可能是降低高血压发病风险的一个良好选择。
