Clinical Study Of Hypertension Combined With Obstructive Sleep Apnea Hypopnea Syndrome

Objective:To study the characteristics of ambulatory blood pressure monitoring in hypertension patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:A total of 111 primary hypertension patients were enrolled in both inpatiemt department and outpatiemt department of Shanxi Province People’s Hospital from January 2017 to January 2018,which were divided into two groups according to polysomnography(PSG): 78 hypertension patients with OSAHS were assigned to OSAHS group and 33 hypertension patients without OSAHS were assigned to non OSAHS group.The characteristics of 24 h dynamic blood pressure monitoring in the two groups of patients was compared.Results:(1)The age,sex,drugs,smoking and drinking history,and family history of the two groups of patients have no significant statistical difference(P>0.05);(2)Four items of blood lipid of the two groups of patients,including serum total cholesterol(CHO),triglyceride(TG),high density lipoprotein cholesterol(HDL),low density lipoprotein cholesterol(LDL-C)have no significant statistical difference(P>0.05);(3)Both body mass index(BMI)and neck circumference are obviously higher in OSAHS group(P<0.001);(4)Compared with non OSAHS group,non dipper blood pressure ratio,24-hour systolic blood pressure(24hSBP)and 24-hour diastolic blood pressure(24hDBP),day diastolic blood pressure(dDBP),night systolic blood pressure(nSBP)and night diastolic blood pressure(nDBP),24-hour systolic blood pressure standard deviation(24hSBPSD),day systolic blood pressure standard deviation(dSBPSD,night systolic blood pressure standard deviation(nSBPSD),and the average heart rate increase significantly in OSAHS group,of which the difference is statistically significant significance(P< 0.05),whlie there is no statistically significant difference in day systolic blood pressure(dSBP),24-hour diastolic blood pressure standard deviation(24hDBPSD),day diastolic blood pressure standard deviation(dDBPSD),and night diastolic blood pressure standard deviation(nDBPSD)between the two groups(P>0.05).(5)Multiple factor regression analysis showes that both the circadian rhythm and the variability of blood pressure are independently correlated to OSAHS(P< 0.005),and both BMI and neck circumference are factors for promoting OSAHS(P< 0.05).Conclusion:Obstructive sleep apnea hypopnea syndrome disturbs the circadian rhythm of blood pressure.In hypertension patients combined with OSAHS,both the proportion of non-dipped blood pressure and the variability of blood pressure increase,of which the increase of systolic blood pressure is the main reason.