Analysis Of The Relationship Between Cardiovascular And Renal Injury And Blood Pressure Variability In Hypertensive Patients With Different Severity Obstructive Sleep Apnea-Hypopnea Syndrome

Background and ObjectiveAbout 56.2% of OSAHS patients in China have hypertension.And long-term hypertension in patients with OSAHS can lead to the damage of multisystem organ structure or function.The increase of BPV can aggravate left ventricular hypertrophy and induce arrhythmia.It can promote vasoconstriction and spasm,promote the rupture of unstable atherosclerotic plaques,etc.It has been found that the increase of BPV in patients with hypertension combined with OSAHS can aggravate the damage of heart target organ.To investigate the relationship between blood pressure variability(BPV)and cardiovascular/renal damage in hypertensive patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).MethodsThis analysis was performed on the data of 146 hypertensive patients,which were diagnosed in Hypertension Department ? Cardiovascular Department and Respiratory Department of Henan Province People's Hospital from September 2012 to February 2015.Patients were identified as four subgroups based on the apnea hyponea index(AHI)and the lowest blood oxygen saturation(SaO2)data which derived according to clinical symptoms and the sleep polysomnography: mild OSAHS group,moderate OSAHS group,severe OSAHS group and hypertension only group Relationships between BPV and cardiovascular/renal damage were analyzed.ResultsCompared with the hypertension only group,the body mass index,fasting plasma glucose,AHI,oxygen desaturation index and the percentage of SaO2< 90% in recording times in the complicated OSAHS patients tended to significantly increased along with the OSAHS severity(P<0.05);meanwhile,their average SaO2 and lowest SaO2 were decreased significantly along with the OSAHS severity(P<0.05).The average systolic/diastolic pressure(24 h daytime and nighttime),and 24 h systolic/diastolic blood pressure variability of the complicated OSAHS patients significantly increased with the OSAHS severity,with the highest record in severe OSAHS group.The decline rate of nighttime systolic/diastolic pressure were significantly different(P<0.05)among four subgroups,and the severe OSAHS group was the lowest.For indexes of the interventricular septal thickness(IVST)[(11.02±1.08)mm,(12.59±1.16)mm,(14.76±1.38)mm],24-hour urinary protein quantity(21.2 mg/24 h,30.7 mg/24 h,40.2 mg/24 h)in the mild,moderate and severe OSAHS complicated with hypertension group were higher than those of the hypertension only group[(10.64±1.23)mm,,15.2 mg/24 h],and these indexes were increased with the OSAHS severity(P<0.05).The left ventricular ejection fraction of the mild,moderate and severe OSAHS groups was lower than that in the hypertension only group(P<0.05),and decreased with the increase of OSAHS severity(P<0.05),.The left ventricular ejection fraction of the mild,moderate and severe OSAHA were positively correlated with BPV(P<0.05).ConclusionThe degrees of cardiovascular and renal damage were positively correlated with the degree of OSAHS.The BPV increases with the increase of OSAHS.