Clinical Observation On Treatment For Hypertension Patients Complicated With OSAHS And Early Morning Blood Pressure Surge With Telmisartan

ObjectivesTo detect serum brain natriuretic peptide and endothelin-1 in hypertension patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and early morning blood pressure surge(EMBPS), and to investgate the therapeutic efficacy of telmisartan .DesignCross-sectional study, Clinical observation.SettingSleeping lab, Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha, China.Participants17 hypertension patients with OSAHS and EMBPS, 23 hypertension patients with OSAHS but without EMBPS, 10 control subjects were recruited.MethodAfter polysomnography(PSG) and ambulatory blood pressure monitoring(ABPM), the venous blood was collected from all subjects to investigate BNP and ET-1 by enzyme-linked immunosorbnent assay. The effects of 30 days treatment of telmisartan on serum levels of BNP and ET-1 were studied in OSAHS patients with EMBPS. The associations among the EMBPS, polysomnographic parameters and the serum levels of BNP and ET-1 were examined by simple regression analysis andstepwise multiple regression analysis.ResultsBefore the treatment, there was a significantly positive correlation between BNP and ET-1 in all subjects(r=0.588, P<0.001). EMBPS showed significant positive correlation with AHI, the longest time of apnea, BNP, ET-1 and ages. The levels of BNP and ET-1 had statistical significance in the three groups of the individuals. Telmisartan decreased the level of EMBPS in hypertension patients with OSAHS and EMBPS, and decreased the level of BNP at the same time. The level of decreased BNP showed significant positive correlation with the level of decreased EMBPS (r=0.527, P<0.05) .ConclusionsThe serum BNP and ET-1 level were markedly higher in OSAHS complicated with early morning blood pressure surge. Telmisartan can palliate the levels of EMBPS of OSAHS patients and decreased the levels of BNP. BNP is a influence factor for predicting the EMBPS of OSAHS patients.