Wang Le, Wei Donghui, Zhang Jing, Cao Jie, Zhang Xinxin
Department of Respiratory and Critical Care, Tianjin Medical University General Hospital, Tianjin, The People's Republic of China.
Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, The People's Republic of China.
Nat Sci Sleep. 2022 Jul 6;14:1249-1258. doi: 10.2147/NSS.S369614. eCollection 2022.
Obstructive sleep apnea (OSA) plays an important role in the pathogenesis of hypertension. The aim of this cross-sectional study was to explore the clinical and polysomnographic characteristics of OSA patients with hypertension and to explore the gender differences in the relationship between rapid eye movement (REM) OSA and hypertension.
A total of 808 patients with OSA at a tertiary hospital were enrolled in this study, and OSA patients were divided into groups presenting with or without hypertension. The clinical and polysomnographic characteristics were compared between the groups. Multivariate binary logistic analysis was performed to assess the association between REM OSA and hypertension.
After adjustment for potential confounders, the risk of hypertension in patients with OSA increased with severity categories of apnea hypopnea index during rapid eye movement sleep stage (REM AHI) (OR = 1.61 for REM AHI ≥58.87 events/h relative to REM AHI <30.50 events/h, 95% CI 1.07-2.42, P = 0.022). Consistent with this, when taken as a continuous variable, this association still remains significant (OR = 1.007, 95% CI 1.001-1.014, P < 0.05). This effect was more pronounced in women patients, the OR for REM AHI ≥57.24 events/h relative to REM AHI <30.36 events/h was 2.79 (95% CI, 1.16-6.73; P = 0.022); however, there was no significant difference in male patients.
REM AHI was significantly and positively associated with hypertension in patients with OSA, and the effect was more pronounced in female patients.
阻塞性睡眠呼吸暂停（OSA）在高血压发病机制中起重要作用。本横断面研究旨在探讨高血压合并OSA患者的临床及多导睡眠图特征，并探讨快速眼动（REM）期OSA与高血压关系中的性别差异。
本研究纳入一家三级医院的808例OSA患者，将OSA患者分为有或无高血压组。比较两组的临床及多导睡眠图特征。进行多因素二元逻辑回归分析以评估REM期OSA与高血压之间的关联。
在对潜在混杂因素进行校正后，OSA患者发生高血压的风险随快速眼动睡眠期呼吸暂停低通气指数（REM AHI）严重程度分级增加而升高（相对于REM AHI <30.50次/小时，REM AHI≥58.87次/小时的患者发生高血压的比值比[OR] = 1.61，95%可信区间[CI] 1.07 - 2.42，P = 0.022）。与此一致的是，将REM AHI作为连续变量时，这种关联仍然显著（OR = 1.007，95% CI 1.001 - 1.014，P < 0.05）。这种效应在女性患者中更为明显，相对于REM AHI <30.36次/小时，REM AHI≥57.24次/小时的女性患者OR为2.79（95% CI，1.16 - 6.73；P = 0.022）；然而，男性患者中无显著差异。
REM AHI与OSA患者的高血压显著正相关，且这种效应在女性患者中更为明显。
