Analysis Of Influencing Factors Of Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) Associated Hypertension

Background and purposeObstructive sleep apnea hypopnea syndrome(OSAHS)is one of the international public health issues related to sleep breathing disorders.During sleep,the upper airway of the OSAHS patients is intermittently obstructed which lead to repeated apnea and hypopnea.The high blood pressure associated with the OSAHS is the associated high blood pressure for obstructive sleep apnea.With social development and the medical technology advances,numbers of people request higher quality of life and OSAHS diagnosis and treatment attract more and more attention.The incidence rate of OSAHS in China has been increasing,as currently the incidence of OSAHS in adults is approximately 2% to 4%.Systemic multi-system disease may gradually arise in OSAHS patients who always have cerebral hypoxia caused by hypoxemia.The OSAHS patients often have excessive daytime sleepiness,fatigue,poor spirit,difficulty concentrating and other symptoms,endocrine disorders and other disorders in the heart,brain,or kidney.Their quality of life,as well as their work efficiency is decreased.Their life safety is seriously threatened with aerial work or in driving the vehicles.Hypertension is a common disease with the incidence rate of 10% to 20% over the world.Hypertension poses a great threat to public health,which brings psychological pressure to the patients and affects their quality of life.The incidence of hypertension is still rising as that the aging process of the population accelerates,and that unhealthy lifestyle overwhelms.Hypertension is an important risk factor for cardiovascular and renal vascular diseases.The prevention and treatment of diseases related to hypertension has been attracting public concerns.Scholars have pointed out that OSAHS is among the pivotal cause of secondary hypertension and there is a great relationship between them.More and more medical experts have carried out the relevant researches.The current research shows that continuous positive airway pressure is a common treatment for OSAHS.Till now most published researchesidentifies single risk factor about OSAHS-related hypertension,so multi-factor research is in need.In this study,we aimed to identify the risk factors and outcomes of OSAHS related hypertension.This study may provide data for elucidating the early diagnosis and prevention about OSAHS.Objects and methodsWe sought the OSAHS patient database to perform this retrospective study.OSAHS cases diagnosed by polysomnography in the People's Hospital of Zhengzhou University(Henan Province People's Hospital)during March 2015 and December2016 are screened.The cases are excluded if their data are insufficient.A questionnaire was designed to collect the data of each patient,including the patient's name,gender,age,occupation,body mass index(BMI),neck circumference,waist circumference,smoking history,drinking history,daytime sleepiness,signs and SBP,DBP and other general information,and polysomnography results such as oxygen saturation and other examination results.According to the expert consensus on diagnosis and treatment of obstructive sleep apnea-related hypertension released in2012,the patients were divided into two groups: the OSAHS-related hypertension group and non-hypertension group.A variety of effects on OSAHS related factors of hypertension were observed,and then the conclusion was recorded and analyzed.Statistical analysis was carried out using SPSS15.0 software,the measurement data are expressed as mean±standard deviation.Grouped data were compared using single factor variance analysis and test.Count data were expressed in percentage or number of cases and compared with test.The Logistic regression analysis of multiple independent variables was performed with high blood pressure.P value of less than0.05 would be considered statistically significant.ResultAfter finishing the above study,we can see that the differences among smoking,daytime sleepiness,family history of hypertension,mandibular retrusion,jaw vertical too long(or too wide),weight,BMI,neck circumference and waist circumference in two groups of patients were statistically significant.We can also see that two groups of patientsAHI(?2= 2.342,P = 0.032),LSaO2(?2=-2.627,P = 0.012),MSaO2(?2 =-2.108,P = 0.043),CT90%(?2 = 2.426,P = 0.031),ODI(?2 = 2.107,P =0.039),arousal index(?2 = 2.074,P = 0.023),the total duration of apnea(?2 = 2.272,P = 0.025),the longest apnea time(?2 = 2.437,P = 0.024)difference was statistically significant,the results show the extent of hypoxia and apnea and hypertension related.In patients with high blood pressure as the dependent variable,smoking daytime sleepiness,family history of hypertension,mandibular retrusion,jaw vertical too long(or too wide),weight,BMI,neck circumference and waist circumference AHI?LSa O2?MSa O2?CT90%?ODI?arousal index,the total duration of apnea,the longest apnea time as the independent variable multiariable logistic regression analysis,the results P values were 0.016,0.009,0.011,0.037,OR values were 3.216,1.147,5.618,3.216,smoking history,BMI and sleepiness during the day and the longest apnea time are independent risk factors of OSAHS associated hypertension.ConclusionConfirmed by this study,OSAHS associates with a higher incidence of hypertension.There is a close relationship between sex,smoking and alcohol use,jaw,tongue,jaw hanging structure,the degree of obesity,the degree of hypoxia,awakening times,male,excessive smoking and drinking,upper respiratory tract collapse obstruction,obesity,hypoxia and the risk of OSAHS-induced hypertension.Among them,smoking,BMI,daytime sleepiness,the longest apnea time,Were independent risk factors for the related hypertension of the OSAHS.