Clinical analysis of the association between obstructive sleep apnea hypopnea syndrome and hypertension / 中国综合临床

ABSTRACT

Objective To study the incidence of hypertension in patients with different severity of obstructive sleep apnea hypopnea syndrome(OSAHS) and to observe the effects of short-term continuous positive airway pressure (CPAP) treatment on hypertension in patients with hypertension Ⅲ complicated with OSAHS.Methods According to sleep apnea hypopnea index (AHI) and the lowest oxygen saturation value at night,184 patients with OSAHS were divided into mild group(n =55),moderate group(n =63) and severe group(n =66).We observed the incidence of hypertension among patients and their mean systolic and diastolic blood pressures before sleep and after wakening.There were 46 patients with severe OSAHS combined with hypertension Ⅲ received short-term (at least 7 days) CPAP treatment.We observed and analyzed the effect of CPAP on blood pressure values.Results In the 184 cases,incidence of hypertension of the three groups were 36.4％ (20/55),42.9％ (27/63) and 62.1％ (41/66) respectively.The incidence of hypertension in OSAHS patients was significantly higher in the severe group than in the moderate group (x2 =4.799,P ＜ 0.05) and the mild group(x2 =7.962,P ＜ 0.05).There were significant differences among mild,moderate and severe OSAHS patients in mean systolic and diastolic blood pressures before sleep Systolic ((135.08 ± 6.71) mm Hg vs.(136.59 ± 15.14) mm Hg vs.(144.73 ± 15.80)mm Hg,F =4.202,P ＜0.05) and Diastolic((90.96 ±6.06)mm Hg vs.(91.41 ± 4.05) mm Hg vs.(94.13 ± 13.97) mm Hg,F =13.690,P ＜ 0.05)) and after wakening Systolic((136.83 ± 8.23) mm Hg vs.(137.89 ± 17.03)mm Hg vs.(148.59 ± 14.83) mm Hg,F =4.158,P ＜0.05) and Diastolic((91.25 ± 9.96) mm Hg vs.(93.40 ± 8.82) mm Hg vs.(98.75 ± 9.39) mm Hg,F =5.638,P ＜0.05)).Severe OSAHS patients had significantly higher systolic and diastolic blood pressures after wakening than before sleeping (P ＜ 0.05).The changes of blood pressure had significant difference after CPAP treatment than before CPAP treatment (Systolic(175.09 ± 9.66) mm Hg vs.(168.22 ± 8.55)mm Hg,t =3.556,P＜0.05;Diastolic(105.82 ± 12.44) mm Hg vs.(100.61 ± 11.26) mm Hg,t =2.741,P ＜0.05).Conclusion OSAHS and hypertension are closely related to each other.CPAP is an effective treatment to OSAHS combined with hypertension.