Ahmed Abass Mahamoud, Nur Salman Mohamud, Xiaochen Yuan
Department of Cardiology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China.
Medical College, Yangzhou University, Yangzhou, Jiangsu, China.
Front Med (Lausanne). 2023 Jun 2;10:1200952. doi: 10.3389/fmed.2023.1200952. eCollection 2023.
Obstructive sleep apnea syndrome (OSAS) is a chronic disorder characterized by recurring episode obstruction and collapse of upper airways during sleep, leading to hypoxia and sleep disruption. OSAS is commonly associated with an increased prevalence of hypertension. The underlying mechanism in OSA with hypertension is related to intermittent hypoxia. This hypoxia induces endothelial dysfunction, overactivity of sympathetic effects, oxidative stress, and systemic inflammation. Hypoxemia triggers the sympathetic process's overactivity, leading to the development of resistant hypertension in OSA. Thus, we hypothesize to evaluate the association between resistant hypertension and OSA.
The PubMed, ClinicalTrails.gov, CINAHL, Google Scholar, Cochrane Library, and Science Direct databases were searched from 2000 to January 2022 for studies demonstrating the association between resistant hypertension and OSA. The eligible articles underwent quality appraisal, meta-analysis, and heterogeneity assessment.
This study comprises seven studies, including 2,541 patients ranged from 20 to 70 years. The pooled analysis of six studies demonstrated that OSAS patients with a history of increased age, gender, obesity, and smoking status are at an increased risk for resistant hypertension (OR: 4.16 [3.07, 5.64], :0%) than the non-OSAS patients. Similarly, the pooled effect demonstrated that patients with OSAS were at an increased risk of resistant hypertension (OR: 3.34 [2.44, 4.58]; :0%) than the non-OSAS patients when all associated risk factors were adjusted using multivariate analysis.
This study concludes that OSAS patients with or without related risk factors demonstrated increased risk for resistant hypertension.
阻塞性睡眠呼吸暂停综合征（OSAS）是一种慢性疾病，其特征是睡眠期间上呼吸道反复出现阻塞和塌陷，导致缺氧和睡眠中断。OSAS通常与高血压患病率增加有关。OSA合并高血压的潜在机制与间歇性缺氧有关。这种缺氧会导致内皮功能障碍、交感神经作用过度活跃、氧化应激和全身炎症。低氧血症引发交感神经过程的过度活跃，导致OSA患者出现顽固性高血压。因此，我们假设评估顽固性高血压与OSA之间的关联。
检索2000年至2022年1月期间的PubMed、ClinicalTrails.gov、CINAHL、谷歌学术、Cochrane图书馆和科学Direct数据库，以查找证明顽固性高血压与OSA之间关联的研究。对符合条件的文章进行质量评估、荟萃分析和异质性评估。
本研究包括七项研究，共2541名年龄在20至70岁之间的患者。六项研究的汇总分析表明，有年龄增长、性别、肥胖和吸烟史的OSAS患者患顽固性高血压的风险（OR：4.16[3.07，5.64]，P<0.001）高于非OSAS患者。同样，当使用多变量分析调整所有相关风险因素时，汇总效应表明OSAS患者患顽固性高血压的风险（OR：3.34[2.44，4.58]；P<0.001）高于非OSAS患者。
本研究得出结论，无论有无相关风险因素，OSAS患者患顽固性高血压的风险均增加。
