Lin Fang-Chi, Cheng Hao-Min, Yih Ming-Ling, Huang Shiang-Fen, Su Kang-Cheng, Chou Kun-Ta, Chen Yuh-Min, Chiu Hwa-Yen
Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; #201 Section 2, Shih-Pai Road, Taipei, 112, Taiwan.
School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; #155 Section 2, Linong Street, Taipei, 112, Taiwan.
Hypertens Res. 2025 Apr;48(4):1379-1388. doi: 10.1038/s41440-024-02079-7. Epub 2025 Jan 27.
To explore the effects of obstructive sleep apnea (OSA) on nocturnal changes in blood pressure (BP), we enrolled 2037 participants who underwent polysomnography (PSG) between 2019 and 2020 and examined BP changes before and after sleep. BP was measured in the evening and the following morning using an electronic wrist sphygmomanometer in the supine position. The severity of OSA was determined by PSG and graded based on the apnea/hypopnea index (AHI). Participants with OSA (AHI ≥ 5 events/h) had significantly higher morning systolic BP (SBP) and diastolic BP (DBP) compared to their evening measurements. BP values, whether measured in the evening or the morning, as well as the nocturnal changes (differences between morning and evening values), showed significant correlations with the AHI for both SBP and DBP, even after adjusting for confounders such as age, sex, body mass index, and the presence of comorbidities, including hypertension, heart failure, coronary artery disease, diabetes, renal disorder, and cerebrovascular attack. After standardization, the extent of nocturnal changes in DBP was greater than SBP, especially among participants with severe OSA. In a logistic regression model with serial multivariate adjustments, OSA was found to be independently associated with morning hypertension, particularly in individuals with moderate to severe OSA.
为探讨阻塞性睡眠呼吸暂停（OSA）对夜间血压（BP）变化的影响，我们纳入了2037名在2019年至2020年间接受多导睡眠图（PSG）检查的参与者，并检测了睡眠前后的血压变化。使用电子腕式血压计在仰卧位测量傍晚和次日早晨的血压。OSA的严重程度由PSG确定，并根据呼吸暂停/低通气指数（AHI）进行分级。与傍晚测量值相比，患有OSA（AHI≥5次/小时）的参与者早晨收缩压（SBP）和舒张压（DBP）显著更高。无论在傍晚还是早晨测量的血压值，以及夜间变化（早晨和傍晚值之间的差异），即使在调整了年龄、性别、体重指数以及合并症（包括高血压、心力衰竭、冠状动脉疾病、糖尿病、肾脏疾病和脑血管意外）等混杂因素后，SBP和DBP的AHI均显示出显著相关性。标准化后，DBP的夜间变化程度大于SBP，尤其是在重度OSA参与者中。在进行系列多变量调整的逻辑回归模型中，发现OSA与早晨高血压独立相关，特别是在中度至重度OSA患者中。
