The risk factors of carotid atherosclerosis in sleep apnea-related hypertension / 中华内科杂志

ABSTRACT

ObjectiveTo investigate the risk factors and morbidity of carotid atherosclerosis (CA) and unstable plague in patients with sleep apnea-related hypertension (SA-RH).MethodsA total of 603 SA-RH subjects screened by polysomnography according to apnea hypopnea index (AHI) were recruited and divided into 3 groupsmild (AHI 5-15 ),moderate (AHI 15-30) and severe (AHI ≥ 30) group,with hypertensive patients with AHI less than 5 served as control.CA was determined by doppler ultrasound as formation of plaque and/or intima-media thickness more than 0.9 mm.Unstable atheroma plaque (UAP) was defined as low echo plaque and/or admixing echo plaque.Results Gender,age,BMI and blood pressure were not matched among groups.The prevalence of CA increased in moderate and severe SA-RH than that in control ( P ＜ 0.01 ) with no significant difference for UAP among groups.Factor analysis was performed to extracted common factors that may influence CA and UAP,such as factor 1-6,represent obstructive sleep apnea (OSA),dyslipidemia (TC,LDL),BMI,blood pressure,age and duration of disease and dyslipidemia (TG,HDL) respectively.Logistic analysis show that OSA and dyslipidemia (TC,LDL) increased the risk of CA,with OR 1.36(95％ CI 1.15-1.59),1.31 (95％ CI 1.12-1.54)respectively,and dyslipidemia (TC,LDL) increased the risk of UAP,with OR 1.30 (95％ CI 1.06-1.58).ConclusionsIn SA-RH populations,higher prevalence of CA may be associated with severity of OSA independently,meanwhile the formation of UAP may be mainly associated with dyslipidemia.