Effect of uvulopalatopharyngoplasty on obstructive sleep apnea hypopnea syndrome in patients with resistant hypertension / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the effect of uvulopalatopharyngoplasty (UPPP) to obstructive sleep apnea hypopnea syndrome (OSAHS) in patients with resistant hypertension (RH).</p><p><b>METHODS</b>UPPP and modified UPPP were performed on 36 moderate and severe OSAHS patients, who also suffered from RH [who taking more than three kinds of antihypertensive drugs (including diuretics) and still not able to control blood pressure at 140/90 mm Hg (1 mm Hg = 0.133 kPa)]. Polysomnography monitoring, ambulatory blood pressure monitoring, apnea hypopnea index (AHI), lowest saturation of blood oxygen (SaO2) and the changes of antihypertensive medication dosage were performed to the patients before and 6 months after the surgery.</p><p><b>RESULTS</b>Six months after surgery,the total efficiency was 61.1% (22/36). The AHI median [25 quartile; 75 quartile] from 37.5 [26.0; 48.3]/h to 9.5 [9.0; 21.3]/h, the lowest the SaO2 average (x(-) ± s, the same below) increased from 0.655 ± 0.114 to 0.860 ± 0.037, the differences were statistically significant (P value < 0.05). 24 h systolic blood pressure, daytime systolic blood pressure, night contraction, diastolic and mean arterial pressure decreased from (160.8 ± 6.8), (170.5 ± 2.5), (163.6 ± 10.5), (100.8 ± 5.6) and (96.8 ± 7.5) mm Hg to (142.5 ± 7.3), (150.8 ± 7.6), (140.1 ± 6.4), (81.8 ± 7.4) and (93.7 ± 2.4) mm Hg, the differences were statistically significant (P < 0.05). The degrees of AHI descent and the average SaO2 improvement were concerned with the degree of systolic blood pressure, diastolic blood pressure decent (r > 0.80 and r(2) > 0.50). The average numbers of antihypertensive drugs decreased form (3.6 ± 0.5) to (2.9 ± 0.5) compared preoperatively and postoperatively, the difference was statistically significant (t = 5.537, P < 0.01). The use of antihypertensive medication reduced in 23 cases (23/36, 63.8%) compared preoperatively and postoperatively.</p><p><b>CONCLUSIONS</b>The blood pressure of the patients with OSAHS and RH dropped significantly after UPPP surgery. Recent follow-up shows that the varieties of antihypertensive drugs taken in these patients are reduced significantly after operation.</p>