Study On Blood Pressure Variability,heart Rate Va Riability And Ventricular Arrhythmia In Hypertensive Patients Complicated With OSAHS

Objective: To investigate the relationship between blood pressure variability,heart rate variability and ventricular arrhythmia in patients with OSAHS complicated with hypertension.Methods: Medical records of 100 patients with OSAHS complicated hypertension and 100 patients without OSAHS caused hypertension were collected.Medical records included general basic data of gender,age,height,weight and BMI,24-hour,daytime and nighttime mean blood pressure,blood pressure variation data such as blood pressure standard deviation and coefficient of blood pressure variation.Heart rate variability data such as SDNN,RMSSD,PNN50,and whether ventricular arrhythmias occurred.Chi-square test or t test were used for statistical analysis.Binary Logistic regression analysis was used to analyze the factors affecting the occurrence of OSAHS,and rank correlation analysis was used to analyze the correlation between blood pressure variability and heart rate variability and ventricular arrhythmia.Results:(11)There were no statistical differences in age and height between the OSAHS combined hypertension group and the non-OSAHS hypertension group(P>0.05),while there were statistical differences in gender,body weight and BMI(P<0.05).(2)The mean blood pressure,blood pressure variability indicators such as blood pressure standard deviation and coefficient of variation were statistically different between the two groups(P<0.05).(3)There were statistical differences in heart rate variability SDNN,RMSSD and PNN50 between the two groups(P<0.05).(4)200 cases were divided into two groups with or without ventricular arrhythmia,and the heart rate variability and blood pressure standard deviation were compared between the two groups.The results showed that there were statistical differences in the heart rate variability indexes SDNN,RMSSD and PNN50 between the two groups(P<0.05),and there was no statistical difference in the standard deviation of blood pressure 24 hours a day,day and night(P>0.05).(5)Chi-square test was conducted on whether ventricular arrhythmias occurred in the OSAHs-complicated hypertension group and the non-OSAHS hypertension group.The results showed a statistical difference(P<0.05).The incidence of ventricular arrhythmias in the OSAhs-complicated hypertension group was higher than that in the non-OSAHs hypertension group.(6)In Logistic regression analysis of factors affecting OSAHS,after adjusting for the confusing effect of age,OR(male,female)=4.36,P<0.05;OR(BMI)=2.05,P<0.05.(7)In the correlation analysis of blood pressure variability,heart rate variability and arrhythmia,blood pressure variability was positively correlated with ventricular arrhythmia(r=0.200,r=0.244,r=0.181,r=0.179,r=0.220,r=0.224,P<0.05),and heart rate variability was negatively correlated with ventricular arrhythmia(r=-0.791,r=-0.765,r=-0.753,P<0.05).Conclusion: In patients with hypertension complicated with OSAHS,the increased sympathetic nerve activity caused by intermittent hypoxia at night can increase the variability of blood pressure and decrease the variability of heart rate,and increase the incidence of ventricular arrhythmia.Heart rate variability decreased in patients with ventricular arrhythmias.