| Objective: to explore effects of short-term continuous positive airway pressure(CPAP) therapy on blood pressure of obstructive sleep apnea hypopnea syndrome(OSAHS) patients with hypertension. Methods: 1.100 polysomnography-determined OSAHS patients with hypertension were recruited from hypertension department of the People’s Hospital of Xinjiang Uygur Autonomous Region through November 2012 to May 2013, and provided with a week of nocturnal CPAP therapy(>6h/night) on the basis of regular anti-hypertensive treatment, and blood pressure values were detected to compare pre-and post-treatment blood pressure; 2. 100 patients were divided into two groups based on gender, males(n=12) and females(n=12); according to their age over or under 60 years old, senile(n=12) and non-senile groups(n=88); based on BMI, Obese group with 74 patients(BMI≥28 kg/m2), Non-obese group with 26 patients(BMI<28 kg/㎡); were divided into three groups based on AHI, mild group with 13 patients(5≤AHI<15), moderate group with 26 patients(15≤AHI<30), severe group with 61 patients(AHI≥30), and blood pressure values were detected to compare pre-and post-treatment blood pressure in and between groups. Results: 1.post-traetment morning diastolic blood pressure(86.1±9.5mm Hg vs 92.1±11.9mm Hg, P < 0.05), morning mean arterial pressure(102.6±9.6mm Hg vs 108.2±12.2mm Hg, P<0.05) were significantly lowered compared to pre-treatment values, and mean arterial pressure decreased gradually during the process(P<0.05). 2. lowering scope of morning diastolic blood pressure was greater at day 7 than at day 1 of CPAP treatment(11.7±13.8mm Hg vs 5.2±11.2mm Hg, P<0.05) and lowering scope of diastolic pressure increased gradually with the CPAP therapy(P<0.05). 3. normalizing rate of diastolic pressure was significantly higher at day 7 than pre-treatment and at day 1(81% vs 34% and 55%, P<0.05).4. post-treatment morning mean blood pressure was significantly lowered at day 7 than pre-treatment in males [(103.4±10.4)m MHg VS(113.4±11.7), P<0.05, 1m MHg=0.133 k Pa], whereas similar results were not observed in females. 5. In the the 7th day after treatment, the morning mean blood pressure(102.6±9.8 vs 109.1±11.7m MHg, P < 0.05) were significantly reduced when compared with the values before treatment in non-senile group. Whereas, no such difference was seen in the senile group(P>0.05).6.Morning mean arterial pressure decrease range at day 7 is significantly higher in obese group than in non-obese group[(6.7±9.5)m MHg VS(4.6±12.3)m MHg,(P<0.05) ].7. post-treatment morning systolic blood pressure[(133.7±14.2)m MHg VS(139.0±15.6)m MHg,(P < 0.05), 1mm Hg=0.133 k Pa], morning diastolic blood pressure[(84.8±10.0)m MHg VS(92.0±12.6)m MHg,(P<0.05) ]was significantly lowered at day 7 than pre-treatment in severe group, while morning diastolic blood pressure[(87.1±9.9)m MHg VS(92.5±10.1)m MHg,(P<0.05) ]in moderate group. whereas similar results were not observed in mild group. Conclusion: short-term CPAP therapy is effective to lower morning blood pressure, particularly diastolic pressure, of OSAHS patients with hypertension, and lowering scope and normalizing rate of blood pressure increase with CPAP therapy duration increasing. Effects of short-term CPAP therapy in males are superior to those of females.Short-term CPAP therapy has better efficiency in non-senile than senile patients in the treatment of OSAHS with coexisting hypertension.Effects of short-term CPAP therapy in obese obstructive sleep apnea syndrome patients combined with hypertension are significant.Effects of short-term CPAP therapy in moderate and severe group are significant. We identify and correct OSAHS in hypertensive patients, and at the same time actively look for the cause of OSAHS, according to the crowd characteristics, the blood pressure characteristics and the severity of their illness, take individual treatment. Continuous positive airway pressure(CPAP);Obstructive sleep apnea... |
PDF Full Text Request