Ambulatory Blood Pressure Variability after Adenotonsillectomy in Childhood Sleep Apnea.
Laryngoscope
; 132(12): 2491-2497, 2022 12.
Article
in En
| MEDLINE
| ID: mdl-35156724
ABSTRACT
OBJECTIVE:
To investigate the influence of adenotonsillectomy (T&A) on ambulatory blood pressure (BP) variability in children with obstructive sleep apnea (OSA). STUDYDESIGN:
Prospective, interventional study.METHODS:
Children with OSA symptoms were recruited from a tertiary center. After OSA diagnosis was confirmed (ie, apnea-hypopnea index [AHI] > 1), these children underwent T&A for treatment. We performed polysomnography and 24-hour recordings of ambulatory BP before and 3 to 6 months postoperatively. Ambulatory BP variability was presented as the standard deviation of mean blood pressure in the 24-hour monitoring of ambulatory BP. Differences in BP variability among different subgroups were tested using a multivariable linear mixed model.RESULTS:
A total of 190 children were enrolled (mean age 7.8 ± 3.3 years; 73% were boys; 34% were obese). The AHI significantly decreased from 12.3 ± 17.0 to 2.7 ± 5.5 events/hr after T&A. Overall, daytime, and nighttime ambulatory BP did not significantly change postoperatively, and overall, daytime, and nighttime ambulatory BP variability did not differ significantly preoperatively and postoperatively. In the subgroup analysis, children aged <6 years demonstrated a significantly greater decrease in ambulatory BP variability postoperatively than those aged >6 years (nighttime diastolic BP variability 9.9 to 7.7 vs. 8.9 to 9.4). Children with hypertension also showed a significantly greater decrease in ambulatory BP variability than those without hypertension.CONCLUSIONS:
We concluded that overall ambulatory BP variability does not significantly change after T&A in children with OSA. Moreover, young-aged and hypertensive children demonstrate a significant decrease in BP variability after T&A. LEVEL OF EVIDENCE 4 Laryngoscope, 1322491-2497, 2022.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Sleep Apnea Syndromes
/
Tonsillectomy
/
Sleep Apnea, Obstructive
/
Hypertension
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Limits:
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Language:
En
Journal:
Laryngoscope
Journal subject:
OTORRINOLARINGOLOGIA
Year:
2022
Document type:
Article
Affiliation country:
Taiwan