Analysis Of Arrhythmia And Heart Rate Variability In Elderly Patients With Hypertension Complicated With Obstructive Sleep Apnea Hypopnea Syndrome

Objective To analyze the effects of obstructive sleep apnea-hypopnea syndrome(OSAHS)on arrhythmia and heart rate variability(HRV)in elderly patients with essential hypertension,and to study elderly hypertension with OSAHS possible mechanisms of related arrhythmias and heart rate variability.Methods According to the standard of admission,120 patients with hypertension in the relevant departments of our hospital and 30 patients in the control group were selected.Both polysomnography(PSG)and 24-hour holter were performed.90 patients with hypertension diagnosed as OSAHS by PSG.According to the apnea hypopnea index(AHI),elderly hypertension combined with OSAHS included elderly hypertension with mild OSAHS(AHI 5-15 times/hour,34 patients),elderly hypertension with moderate OSAHS The group(AHI >15-30 times / hour,27 cases)and elderly hypertension combined with severe OSAHS group(AHI > 30 times / hour,29 cases).The clinical baseline data,sleep-related indicators,incidence of arrhythmia,HRV time domain and frequency domain were compared among all subjects.The effects of OSAHS on arrhythmia and heart rate variability in elderly patients with essential hypertension were analyzed.Results:1.Arrhythmia: sporadic atrial premature beats(78.9%),occasional premature ventricular contractions(73.3%),short-term atrial tachycardia(27.8%),and sinus bradycardia(21.1%)in elderly patients with hypertension complicated with OSAHS see,high-risk arrhythmias such as short-term atrial tachycardia(44.8%),sinus arrest(24.1%),sinus bradycardia(37.9%)caused by severe OSAHS patients,and light hypertension with senile hypertension the difference in OSAHS was statistically significant(P < 0.0166).2.Heart rate variability:(1)120 elderly hypertensive patients with SDNN,rMSSD and 30 control group significantly decreased,and significantly decreased with the increase of sleep-disordered breathing,the difference was statistically significant(P <0.05);(2)120 elderly The LF,LF/HF of hypertensive patients were significantly higher than that of the 30 control group,and increased significantly with the increase of sleep-disordered breathing.The HF of 120 elderly hypertensive patients was significantly lower than that of the 30 control group.The severity of sleep-disordered breathing was significantly reduced,and the difference was statisticallysignificant(P<0.05).Conclusion 1.The incidence of arrhythmia in elderly hypertensive patients with OSAHS is higher than that in elderly hypertensive patients,and the arrhythmia rate increases with the aggravation of sleep-disordered breathing,especially high-risk arrhythmia;2.Older hypertension combined with OSAHS is higher than the elderly Heart rate variability is reduced in patients with blood pressure,OSAHS is an important factor in the further reduction of heart rate variability in elderly hypertension;3.Chronic intermittent hypoxemia is an important mechanism for arrhythmia and heart rate variability induced by OSAHS in elderly patients with hypertension;4.OSAHS is a risk factor for cardiovascular events in the elderly.