Characteristics Of Cardiovascular Injury In Young And Middle-aged Patients With Hypertension Complicated With Obstructive Sleep Apnea Hypopnea Syndrome

Objective:1.To investigate the characteristics of basic test indexes in young and middle-aged patients with hypertension complicated with obstructive sleep apnea hypopnea syndrome（OSAHS）and its relationship with cardiovascular diseases.2.To analyze the influencing factors of cardiovascular injury in young and middle-aged patients with hypertension complicated with obstructive sleep apnea hypopnea syndrome.Methods:Continuous collecting data from 146 patients with high blood pressure,who attended polysomnography due to snoring,daytime sleepiness symptoms and sleep apnea in the first hospital of shanxi medical university from September 2018 to October 2020.These patients were divided into four groups according to the sleep apnea hypopnea index（AHI）.The simple hypertension group 19 cases（AHI < 5 times per hour）,31 cases of hypertension with mild OSAHS group（5≤AHI ≤15 times per hour）,hypertension with moderate OSAHS group 43 cases（15 < AHI ≤ 30 times per hour）,53 cases of hypertension complicated with severe OSAHS group（AHI > 30 times per hour）were studied,and the subjects ranged in age from 18 to 65 years old,regardless of gender.We Sorted out their information included the age,weight,BMI,the history of smoking and alcohol and other basic information,serological indexes such as blood routine,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,Gamma-glutamyl transferase（GGT）,total cholesterol（TC）,triglyceride（TG）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C）,fasting blood glucose（FBG）and homocysteine（HCY）,uric acid（UA）and so on,and ankle-brachial index（ABI）,brachial-ankle pulse wave velocity（ba PWV）inspection data.Statistical analysis of the data was conducted to compare the correlation between related inflammatory indicators and disease severity in young and middle-aged patients with hypertension complicated with obstructive apnea hypopnea syndrome and its relationship with cardiovascular disease.Results:1.The BMI of hypertension complicated with severe OSAHS group was significantly higher than that of simple hypertension group,hypertension complicated with mild and moderate hypertension group（P < 0.05）.There were no significant differences in gender,age,course of hypertension,average heart rate,smoking and drinking alcohol history,and complication of cardiovascular disease among all groups（P > 0.05）.2.The comparison results of AHI,average SpO₂,minimum SpO₂ and ODI among all groups showed that there were statistically significant differences between the simple hypertension group and the group with moderate and severe OSAHS（P < 0.05）,but no statistical significance between the simple hypertension group and the group with mild OSAHS（P > 0.05）.There was statistical significance in hypertension complicated with mild,moderate and severe OSAHS among all groups（P < 0.05）.3.According to the laboratory test results,FBG in hypertension complicated with severe OSAHS group was statistically significant compared with the other three groups（P <0.05）,but there was no statistically significant difference among the other groups;There were statistically significant differences in TC,LDL,HCY,UA,HCT,PLR and ALT among the four groups,while there were no statistically significant differences in TG,HDL,RDW,MPV,NLR and GGT.4.AHI in hypertension with OSAHS group was correlated with BMI,DBP,mean SpO₂,minimum SpO₂,ODI,FBG,TG,HCY,UA,HCT,LYM and PLR.5.There were no statistically significant differences in LVEDd,LVEF,ABI and ba PWV between the simple hypertension group and the hypertension group with mild,moderate and severe OSAHS.IVST in hypertension complicated with severe OSAHS group was statistically significant compared with the other three groups（P < 0.05）,but there was no statistically significant difference among the other groups.There was a statistically significant difference in FMD between the simple hypertension group and the combined mild,moderate and severe OSAHS group,and there was a statistically significant difference in FMD between the combined mild and moderate OSAHS group and the severe OSAHS group.6.Pearson correlation analysis was performed for the hypertension group with OSAHS,and the results showed that IVST was correlated with age,BMI,AHI,SBP,DBP,ODI,FBG and HDL.FMD was correlated with age,BMI,AHI,SBP,DBP,ODI,HCY,UA and MPV.The results of multiple linear regression equation showed that SBP,FBG and HDL were the influencing factors of IVST in hypertension patients with OSAHS group.It was suggested that age and AHI were the influencing factors of FMD in hypertension patients with OSAHS.Conclusion:1.A number of inflammatory indicators in the young and middle-aged of simple hypertensive group and the hypertensive group combined with OSAHS were higher than the benchmark,and increased with the severity of OSAHS,but there was no significant statistical difference between the groups.2.In young and middle-aged patients with hypertension combined with OSAHS,AHI was correlated with BMI,DBP,mean SpO₂,minimum SpO₂,ODI,FBG,TG,HCY,UA,HCT,LYM and PLR.3.In the young and middle-aged hypertension complicated with OSAHS group,SBP,FBG and HDL were the influencing factors of IVST value;Age and AHI were the influencing factors of FMD in young and middle-aged hypertension complicated with OSAHS group.4.Compared with patients with simple hypertension group,the blood lipid,blood glucose and various inflammatory indicators of young and middle-aged patients with hypertension combined with severe OSAHS were significantly more abnormal,and patients with hypertension combined with severe OSAHS suffered cardiovascular injury easily.