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Blood pressure after surgery among obese and nonobese children with obstructive sleep apnea

Yen-Lin Kuo1, Kun-Tai Kang2, Shuenn-Nan Chiu3

  • 1Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan Department of Otolaryngology, National Taiwan University Hospital, Hsin-chu Branch, Taipei, Taiwan.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|May 9, 2015
PubMed

Insights

Adenotonsillectomy (T&A) significantly reduces blood pressure in nonobese children with obstructive sleep apnea (OSA). Obese children with OSA show less improvement in blood pressure after T&A surgery.

Area of Science:

  • Pediatric Sleep Medicine
  • Cardiovascular Health in Children
  • Surgical Outcomes

Background:

  • Obstructive sleep apnea (OSA) is common in children and linked to cardiovascular issues.
  • Adenotonsillectomy (T&A) is a primary treatment for pediatric OSA, often associated with blood pressure reduction.
  • The impact of obesity on T&A's effectiveness in improving blood pressure in children with OSA is not well-defined.

Purpose of the Study:

  • To investigate the effect of adenotonsillectomy (T&A) on blood pressure in obese versus nonobese children diagnosed with obstructive sleep apnea (OSA).
  • To determine if obesity influences the cardiovascular benefits of T&A in pediatric OSA patients.

Main Methods:

  • A case series with chart review was conducted at a tertiary referral center.
  • 78 children with OSA were included and matched using propensity scores into obese (n=39) and nonobese (n=39) groups.
  • Blood pressure was measured preoperatively and within 3 months post-T&A, including nocturnal and morning readings.

Main Results:

  • Nonobese children experienced significant reductions in nocturnal diastolic blood pressure (DBP) index and morning systolic blood pressure (SBP) and DBP post-T&A.
  • Obese children showed no significant changes in blood pressure parameters after surgery.
  • Analysis revealed superior blood pressure improvements in nonobese children compared to obese children following T&A.

Conclusions:

  • Nonobese children with OSA demonstrate greater blood pressure improvements after T&A compared to their obese counterparts.
  • Obese children with OSA may experience diminished cardiovascular benefits from T&A.
  • These findings suggest obesity could be a factor limiting the effectiveness of T&A in managing cardiovascular risks associated with pediatric OSA.
Abstract

Keywords:
adenotonsillectomyblood pressurechildobesitysleep apnea syndromestonsillectomy

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