The Clinical Study About Blood Pressure Variability Of Hypertensive Patients With Obstructive Sleep Apnea Syndrome

Background: The incidence of Obstructive sleep apnea syndrome(OSAS) in adult males is 3%- 7%, while in adult females is 2%-5%,and the detection rate of OSAS in patients with high blood pressure is as high as 50%,but now the interaction mechanism between them is still not clear.Objective: To discuss the impact of Obstructive sleep apnea syndrome(OSAS) on blood pressure levels, circadian rhythm, and blood pressure variability of patients with essential hypertension(EH). Method: Selecting 94 cases of patients with high blood pressure of cardiovascular ward in our hospital,walking with 24-hour ambulatory blood pressure monitoring(24h abpm) and polysomnography(PSG).It is divided into three groups for controlled trials according to the apnea hypoventilation index(AHI).There are 49 cases in Simple essential hypertension group named group A,25 cases in high blood pressure with mild OSAS group named group B,20 cases in high blood pressure with moderately severe OSAS group named group C. Making statistical analysis of research data,comparing the differences of blood pressure levels, circadian rhythm, and blood pressure variability(BVP) of the three groups. Exploring the correlation of hypertension patients with OSAS with blood pressure level, blood pressure variability and the inner link between them.Results:(1) There was no difference in the groups of baseline data contrast,P>0.05;(2) The contrasting group A and group C, the contrasting group B and group C,24 hours, daytime and nighttime blood pressure level difference both have statistical significance,P<0.05; Group B compared with group A, throughout the day, the daytime blood pressure level is rising, but there was no statistically significant difference,P>0.05; There are statistical differences in the rising of night blood pressure,P<0.05.(3) The contrasting group A and group C, the contrasting group B and group C, ratio of the dipper type blood pressure of Group C increases significantly, the difference is statistically significant,P<0.05; The contrasting group B and group A, ratio of the dipper type blood pressure of Group C also increases significantly, the difference is statistically significant as well,P<0.05;(4) The contrasting group A and group C, the contrasting group B and group C,allday, daytime and nighttime blood pressure variability both have statistical significance.P<0.05.Group B compared with group A, there are statistical differences allday, daytime and nighttime blood pressure variability,P<0.05;(5) Comparing two groups of sleep respiratory parameters there were statistically significant differences, P < 0.01;(6) According to the correlation analysis of Pearson, sleep respiratory parameters AHI of group A,min Sa O2 and throughout the day, daytime and nighttime systolic blood pressure, diastolic blood pressure variation coefficient linear analysis while r values are not zero, but there is no statistically significant difference, P > 0.05, so that no correlation. Group B and group C, sleep respiratory parameters AHI min Sa O2 and throughout the day, daytime and nighttime systolic blood pressure, diastolic blood pressure variation coefficient is significant positive correlation, P < 0.01.Conclusion:(1) Hypertension combined OSAS patients compared with simple hypertension patients have higher blood pressure levels, and united in hypertension patients with moderately severe OSAS is more obvious, the rising of blood pressure levels is larger in the night hours than during the day, speculated that OSAS can increase blood pressure levels in patients with high blood pressure, and influence on nocturnal blood pressure level is more(2) Combined OSAS patients compared with simple hypertension patients with non dipper type blood pressure ratio increased significantly, deducing that OSAS changes circadian rhythm of patients with high blood pressure.(3) Combined OSAS patients compared with simple hypertension patients blood pressure variation is higher, and in patients with hypertension combined moderately severe OSAS is more apparent. OSAS and the severity of the patients with high blood pressure of blood pressure variability correlation, and positively correlated.(4) Combination of mild OSAS patients compared to pure hypertension patients all the daytime blood pressure levels and no significant difference, but the blood pressure variation is different, speculated that hypertension OSAS patients blood pressure variation, effect on the blood pressure variation may last from night to day, and this effect may be independent of blood pressure levels.(5) Inferring OSAS may be one of the causes of resistant hypertension.