黒人 の 中 で の 睡眠 呼吸 停止 と 血圧 制御 の 関係
Dayna A Johnson1,2,3, S Justin Thomas4, Marwah Abdalla5
1Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA (D.A.J., N.G., M.R., S.R.).
Circulation
|December 28, 2018
まとめ
治療されていない中度または重度の阻害性睡眠時無呼吸 (OSA) は,黒人成人における抵抗性高血圧の確率を大幅に増加させる. これは,OSAがこの集団における制御不能の血圧の重要な要因である可能性を示唆しています.
科学分野:
- 心臓病科
- 睡眠医学
- 公衆衛生
背景:
- 黒人の成人では高血圧と制御不能な血圧の有病率が高い.
- 治療されていない睡眠時無呼吸は,この集団における高血圧に寄与する潜在的な要因です.
研究 の 目的:
- 睡眠時無呼吸と制御不能の血圧 (BP) と黒人の耐性高血圧との関連を調査する.
主な方法:
- ジャクソン・ハート・スリープ・スタディ (N=913) のデータと家庭での睡眠無呼吸試験と臨床血圧測定を用いた.
- 呼吸器イベント指数 ≥15による中度/重度の阻害性睡眠時無呼吸症 (OSA) と,睡眠時間の%による夜間低酸素症と<90%のオキシヘモグロビン飽和度.
- 多変数調整後の関連を分析するために多項論理回帰を用いた.
主要な成果:
- 高血圧患者 (N=664) のうち,OSAは25. 7%,未治療は94%でした. 48%は高血圧を制御できず,14%は耐性高血圧でした.
- 中度または重度のOSAは,耐性高血圧の2. 0倍高い確率と関連していた (95%CI,1. 14~3. 67).
- 夜間低酸素症のSD増加は,耐性高血圧の確率比1. 25と相関していた (95%CI,1. 01-1.55). OSAは制御不能な血圧と関連していなかった.
結論:
- 未治療の中度または重度のOSAは,黒人成人における耐性高血圧の確率の増加と有意に関連しています.
- 治療されていないOSAは,この集団における不十分な血圧制御に役割を果たす可能性があることを示唆しています.
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