Moon Jeonggeun, Park Jae Hyoung, Cho Seo-Eun, Ko Kwang-Pil, Shin Seung-Heon, Kim Ji-Eun, Ryu Jae Kean, Kang Seung-Gul
Division of Cardiology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Department of Cardiology, Korea University Anam Hospital, Seoul, Korea.
Clin Psychopharmacol Neurosci. 2022 Aug 31;20(3):440-449. doi: 10.9758/cpn.2022.20.3.440.
This study aimed to compare the mean pulse rate (PR) and mean blood pressure (BP) between patients with obstructive sleep apnea (OSA) and those with simple snoring (SS) during a 24-hour period, and to investigate the correlation between apnea-hypopnea index (AHI), PR, and BP in sleep-related breathing disorder (SRBD) patients with and without hypertension, diabetes mellitus (DM), and cardiovascular diseases (CVDs).
Ninety SRBD patients underwent full-night polysomnography, and ambulatory BP and PR were monitored for 24 hours. Participants were classified into OSA (AHI ≥ 5) and control (SS) (AHI < 5) groups, and BP and PR were compared. Participants were also divided into groups with and without hypertension, CVDs, or DM to analyze the correlation between AHI, BP, and PR in each group.
Mean PRs during the daytime period and during the whole 24-hour period in the OSA group were significantly higher than those in the SS group after controlling for potential confounders. No significant difference was observed in mean BP between the groups. Partial correlation analysis after controlling for confounders showed significant correlation between AHI and PR during daytime and the 24-hour period in participants without hypertension, DM, or CVDs, but not in participants with these conditions.
The significant differences and correlations only in PR (not in BP) found in this study suggest that PR could be an early marker for SRBD in individuals without comorbidities, and that an increased sympathetic tone could be responsible for future occurrence of CVD.
本研究旨在比较阻塞性睡眠呼吸暂停（OSA）患者和单纯打鼾（SS）患者在24小时内的平均脉率（PR）和平均血压（BP），并调查有无高血压、糖尿病（DM）和心血管疾病（CVD）的睡眠相关呼吸障碍（SRBD）患者的呼吸暂停低通气指数（AHI）、PR和BP之间的相关性。
90例SRBD患者接受了整夜多导睡眠图检查，并监测24小时动态血压和PR。参与者被分为OSA组（AHI≥5）和对照组（SS）（AHI<5），比较两组的血压和PR。参与者还被分为有或无高血压、CVD或DM的组，以分析每组中AHI、BP和PR之间的相关性。
在控制潜在混杂因素后，OSA组白天和整个24小时期间的平均PR显著高于SS组。两组间平均血压无显著差异。在控制混杂因素后的偏相关分析显示，在无高血压、DM或CVD的参与者中，白天和24小时期间AHI与PR之间存在显著相关性，但在有这些疾病的参与者中则无。
本研究中仅在PR（而非BP）方面发现的显著差异和相关性表明，PR可能是无合并症个体SRBD的早期标志物，交感神经张力增加可能是未来发生CVD的原因。
