Tianjin Medical Journal

Tianjin Med J ›› 2015, Vol. 43 ›› Issue (10): 1147-1151.doi: 10.11958/j.issn.0253-9896.2015.10.017

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The prevalence of hypertension in patients with obstructive sleep apnea hypopnea#br# syndrome and their relationship

  

  1. 1 Department of Occupational Disease, The Second Affiliated Hospital of Shandong University of Traditional Chinese
    Medicine, Jinan 250001, China; 2 Department of Respiratory Medicine, General Hospital of Tianjin Medical University
  • Received:2015-06-05 Revised:2015-07-06 Published:2015-10-15 Online:2015-10-22

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Abstract:

Abstract： Objective To investigate the prevalence of hypertension in patients with obstructive sleep apnea hypopnea
syndrome (OSA) and the relationship between blood pressure (BP) with respiratory ventilation function. Methods Patients
with OSA (n=3 607) were included in this study and divided into 4 groups based on their apnea- hypopnea index (AHI)
scores: control group (control, n=354) with AHI<5; mild OSAHS (mild, n=658) with 5≤AHI<15; moderate OSAHS (moder⁃
ate, n=753) with 15≤AHI<30; and severe OSA (severe, n=1 842) with AHI≥30. BP were measured at 4 time points (daytime,
evening, midnight, and morning). The midnight / daytime average BP (RN/D) and morning/evening average BP (RM/E) ratios
were calculated. Finally, the general profiles, prevalence of hypertension and average BP of 4 time points were compared
among 4 groups. The correlations of MBP with AHI and LSaO2 were also analyzed. Results The prevalence of hypertension
as well as MBP at daytime and in the morning in the mild group (34.65% ), moderate group (39.04% ) and severe group
(55.37%) were all higher than that in control group (22.32%)(all P < 0.05). The prevalence of hypertension as well as MBP at
daytime and in the morning were both higher in severe group than those in mild and moderate groups. MPB in the evening
and at midnight was higher in severe group than that in moderate group than that in mild group than in control group (P <
0.05). Average MBP of all four time points rise with increasing AHI (all P < 0.05). The ratios of nighttime to daytime MBP
(RN/D) and of morning to evening MBP (RM/E) increased with the severity of the illness (F=9.821, 18.957; P < 0.001). The day⁃time BP correlated well with AHI and lowest oxygen saturation (LSaO2; systolic BP, r=0.195, -0.206; diastolic BP, r=0.248, -
0.251, P < 0.01). Daytime MBP increased gradually with increasing AHI until MPB reached 61-65, at which point it either
plateaued or dropped slightly. Conclusion OSA patients have a significant increase in midnight and morning BP and
lose normal BP nycterohemeral rhythm. OSA is an independent risk factor for hypertension.

Key words: sleep apnea, obstructive, hypertension, blood pressure, circadian variation, AHI, LSaO2