Analysis Of Blood Pressure Variability In Hyperpietic Invalids With Obstructive Sleep Apnea Syndrome Merged With Sputum And Syndrome Of Blood Stasis

Objective:To investigate the characteristics of blood pressure variability in patients with hypertension complicated with obstructive sleep apnea syndrome(OSAS)by monitoring 24-hour dynamic blood pressure and polysomnography.Methods:A total of206 hypertension patients with dialectical syndrome of mutual association of phlegm and blood stasis were collected from the department of hypertension in the TCM Hospital of Xinjiang Uygur Autonomous Region from January 2019 to December 2020.They were divided into 4 groups by monitoring 24-hour dynamic blood pressure and polysomnograms:There were 43 cases in the simple HBP group,70 cases in the HBP group combined with mild OSAS group,55 cases in the HBP group combined with moderate OSAS group,and 38 cases in the HBP group combined with severe OSAS group.One-way ANOVA and multiple linear regression analysis were performed on the study data to compare the variation of blood pressure at 24 hours,during the day and at night among the 4 groups,and to explore the influencing factors of blood pressure variation.Results:There were significant differences in BMI between HBP combined with serious OSAS group and HBP group and HBP merged with medium OSAS group(P<0.05).It was suggested that BMI of HBP patients with severe OSAS(29.3±3.6Kg/m~2)was significantly higher than that of HBP patients with mild OSAS(25.9±3.2Kg/m~2)and HBP invalids with medium OSAS(26.9±3.1Kg/m~2).The 24-hour blood pressure variability of HBP invalids with severe OSAS group was(14.6/13.1±3.4/3.6mm Hg)significantly increased compared with HBP group(12.0/10.4±2.7/2.2mm Hg)and HBP group(13.4/10.9±3.1/2.4mm Hg).Nocturnal blood pressure variability(12.8/12.3±3.5/3.2mm Hg)in hypertensive patients with severe OSAS and in hypertensive patients with simple OSAS(9.1/8.1±2.4/2.2mm Hg)and hypertensive patients with mild OSAS(9.5/8.7±3.7/2.6mm Hg)and hypertension with moderate OSAS group(9.7/9.0±3.5/2.5mm Hg)were significantly increased(all P<0.05).Multiple linear regression analysis showed that sleep apnea hypopnea index was an important factor affecting nocturnal systolic blood pressure variation and diastolic blood pressure variation in patients with OSAS(P<0.01).Conclusion:Hypertensive patients with severe OSAS have significantly increased body mass index and blood pressure variability,and sleep apnea hypopnea index is an important reason for the increase of nocturnal blood pressure variability in patients with hypertension and OSAS.