Lies A, Nabe B, Pankow W, Kohl F V, Lohmann F W
Innere Medizin III, Krankenhaus Neukölln, Berlin, Germany.
Z Kardiol. 1996;85 Suppl 3:140-2.
We studied 24-h blood pressure (BP) in 17 hypertensive patients with polysomnographic verified moderate to severe obstructive sleep apnea (OSA) before, after 1-3 days and after 4-6 months of treatment with nasal continuous positive airway pressure (nCPAP). BP was recorded using an ambulatory blood pressure monitoring (ABPM) device with oscillometric measurement method (SpaceLabs 90207) over a period of 24 h with intervals of 15 min in daytime and nighttime. Hypertension was defined as mean BP in the daytime period > 135/85 mm Hg; OSA was diagnosed when a full night polysomnography indicated an apnea hypopnea index (AHI) > 10/h. Hypertensive systolic/diastolic daytime BP values decreased significantly from 144.8/94.4 mm Hg at baseline to 138.9/89.4 mm Hg after short-term, and to 136.4/86.9 mm Hg after long-term nCPAP-therapy. Nighttime BP values, too, were reduced significantly from 137.6/87.1 mm Hg at baseline to 129.9/82.3 mm Hg after short-term, and to 128.6/ 79.8 mm Hg after long-term therapy. In addition to these data the heart rate fell significantly from 82.5 b/min to 74.8 b/min after 4-6 months in daytime, and from 70.9 b/min to 63.6 b/min in nighttime. The beneficial effect on diurnal and nocturnal hypertension in patients with nCPAP-therapy of OSA suggests a causal relationship between systemic hypertension and obstructive sleep apnea.
我们对17例经多导睡眠图证实为中度至重度阻塞性睡眠呼吸暂停（OSA）的高血压患者，在使用鼻持续气道正压通气（nCPAP）治疗前、治疗1 - 3天后以及治疗4 - 6个月后，进行了24小时血压（BP）研究。使用采用示波测量法的动态血压监测（ABPM）设备（SpaceLabs 90207）记录血压，记录时长为24小时，白天和夜间测量间隔均为15分钟。高血压定义为白天平均血压>135/85 mmHg；当整夜多导睡眠图显示呼吸暂停低通气指数（AHI）>10/小时时，诊断为OSA。高血压患者白天收缩压/舒张压值从基线时的144.8/94.4 mmHg显著下降至短期治疗后的138.9/89.4 mmHg，以及长期nCPAP治疗后的136.4/86.9 mmHg。夜间血压值也从基线时的137.6/87.1 mmHg显著下降至短期治疗后的129.9/82.3 mmHg，以及长期治疗后的128.6/79.8 mmHg。除这些数据外，心率在4 - 6个月后白天从82.5次/分钟显著降至74.8次/分钟，夜间从70.9次/分钟降至63.6次/分钟。nCPAP治疗OSA患者对昼夜高血压的有益作用表明系统性高血压与阻塞性睡眠呼吸暂停之间存在因果关系。
