Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, NO. 91 Tianchi Road, 830001, Urumqi, Xinjiang, China.
National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, China.
BMC Cardiovasc Disord. 2023 Nov 21;23(1):574. doi: 10.1186/s12872-023-03595-z.
The goal of blood pressure (BP) control will be lower when hypertensive patients have comorbidities that can affect the risk of cardiovascular diseases. But, the goal of BP control for hypertensive patients coexistent with obstructive sleep apnea (OSA) is not discussed, which is a special population at high risk of cardiovascular diseases.
Using data from a retrospective study(Urumqi Research on Sleep Apnea and Hypertension (UROSAH) study, we enrolled 3267 participants who were diagnosed with hypertension and performed polysomnography during 2011-2013 to explore the association between BP control and long-term major adverse cardiovascular and cerebrovascular event (MACCE). Outcomes of interest was the levels of BP control, MACCE, cardiac event and cerebrovascular event. Then we calculated the cumulative incidence of MACCE and performed Cox proportional hazards with stepwise models.
379 of 3267 patients experienced MACCE during a median follow-up of 7.0 years. After full risk adjustment, BP control of 120-139/80-89mmHg was associated with the lowest risk of cerebrovascular event (HR: 0.53, 95%CI:0.35-0.82) rather than MACCE and cardiac event in the total cohort. The association did not change much in patients with OSA. When the SBP and DBP were discussed separately, the SBP control of 120-139mmHg or < 120mmHg was associated with the decreased incidence of MACCE and cerebrovascular event. When DBP control < 80 mm Hg, the risk of cerebrovascular event showed 54% decrease [(HR:0.46, 95%CI: 0.25-0.88)] in patients with hypertension and OSA.
In this retrospective study, antihypertensive-drug-induced office and home BP control at 120-139/80-89mmHg showed possible beneficial effect on incident MACCE. However, current results need to be verified in future studies.
患有可影响心血管疾病风险的合并症的高血压患者，血压（BP）控制的目标会更低。但是，患有阻塞性睡眠呼吸暂停（OSA）的高血压患者的 BP 控制目标尚未讨论，这是心血管疾病高危的特殊人群。
使用回顾性研究（乌鲁木齐睡眠呼吸暂停与高血压研究（UROSAH））的数据，我们纳入了 3267 名在 2011-2013 年间被诊断为高血压并接受多导睡眠图检查的患者，以探讨 BP 控制与长期主要不良心血管和脑血管事件（MACCE）之间的关系。感兴趣的结果是 BP 控制水平、MACCE、心脏事件和脑血管事件。然后，我们计算了 MACCE 的累积发生率，并使用逐步模型进行 Cox 比例风险分析。
在中位随访 7.0 年期间，3267 例患者中有 379 例发生 MACCE。在充分调整风险后，120-139/80-89mmHg 的 BP 控制与总队列中脑血管事件（HR：0.53，95%CI：0.35-0.82）而不是 MACCE 和心脏事件的风险最低相关。在 OSA 患者中，该关联变化不大。当分别讨论 SBP 和 DBP 时，120-139mmHg 或 <120mmHg 的 SBP 控制与 MACCE 和脑血管事件发生率降低相关。当 DBP 控制 <80mmHg 时，高血压和 OSA 患者的脑血管事件风险降低 54%[（HR：0.46，95%CI：0.25-0.88）]。
在这项回顾性研究中，降压药物诱导的诊室和家庭 BP 控制在 120-139/80-89mmHg 可能对 MACCE 事件的发生有有益的影响。然而，目前的结果需要在未来的研究中得到验证。
