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Ambulatory Blood Pressure Variability after Adenotonsillectomy in Childhood Sleep Apnea

Kun-Tai Kang1,2,3, Shuenn-Nan Chiu4, Wen-Chin Weng4,5

  • 1Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.

The Laryngoscope
|February 14, 2022
PubMed

Insights

Adenotonsillectomy (T&A) did not significantly alter overall blood pressure (BP) variability in children with obstructive sleep apnea (OSA). However, younger children and those with hypertension showed improved BP variability post-T&A.

Area of Science:

  • Pediatric Sleep Medicine
  • Cardiovascular Physiology
  • Surgical Outcomes

Background:

  • Obstructive sleep apnea (OSA) in children is associated with cardiovascular complications, including altered blood pressure (BP) regulation.
  • Ambulatory blood pressure (BP) variability is an important marker of cardiovascular risk.
  • Adenotonsillectomy (T&A) is the primary treatment for pediatric OSA, but its effect on BP variability is not fully understood.

Purpose of the Study:

  • To evaluate the impact of T&A on 24-hour ambulatory BP variability in children diagnosed with OSA.
  • To identify potential subgroups of children who may experience greater benefits in BP variability after T&A.

Main Methods:

  • A prospective, interventional study involving 190 children with confirmed OSA.
  • Polysomnography and 24-hour ambulatory BP monitoring were conducted before and 3-6 months after T&A.
  • Multivariable linear mixed models were used to analyze changes in BP variability, with subgroup analyses based on age and hypertension status.

Main Results:

  • T&A significantly reduced the apnea-hypopnea index (AHI) in all participants.
  • Overall ambulatory BP and BP variability did not significantly change after T&A.
  • Children younger than 6 years and those with pre-existing hypertension demonstrated a significant reduction in BP variability postoperatively.

Conclusions:

  • While T&A does not uniformly improve BP variability in all children with OSA, it offers significant benefits for younger children and those with hypertension.
  • These findings suggest that T&A may have a targeted positive effect on cardiovascular regulation in specific pediatric OSA populations.
Abstract

Keywords:
Adenoidectomyambulatory blood pressure monitoringblood pressurechildsleep apnea syndromestonsillectomy

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