阻塞性睡眠呼吸暂停和高血压介导的器官损伤在非抗性和抗性高血压中
Mayara L Cabrini1, Thiago A Macedo2, Emerson Castro2
1Unidade de Hipertensão, Departamento de Clinica Medica, Disciplina de Nefrologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
概括
阻塞性睡眠呼吸暂停 (OSA) 与耐性高血压 (RH) 患者的左心室缩 (LVH) 有关. 这一发现表明OSA可能会影响RH及其相关器官损伤的预后.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 高血压研究 高血压研究
背景情况:
- 高血压中介器官损伤 (HMOD) 是心血管健康的一个重大问题.
- 阻塞性睡眠呼吸暂停 (OSA) 和HMOD之间的相互作用,特别是在耐性高血压 (RH) 中,需要进一步调查.
- 耐性高血压 (RH) 定义为不受控制的血压,尽管最佳的药物治疗方案.
研究的目的:
- 调查阻塞性睡眠呼吸暂停 (OSA) 和高血压介导器官损伤 (HMOD) 在耐性高血压 (RH) 患者之间的关联.
- 在RH的背景下,确定受OSA影响的特定HMOD参数.
- 确定OSA是否是RH患者LVH的独立预测因子.
主要方法:
- 100名高血压患者的队列接受了临床评估和睡眠研究,以诊断OSA (呼吸暂停-呼吸暂停指数≥15次/小时).
- 通过左心室缩 (LVH),动脉硬,视网膜病变和病变来评估HMOD.
- 使用门诊血压监测证实了抗性高血压 (RH).
主要成果:
- 在52%的高血压患者中检测到OSA.
- 在RH患者中,OSA与左心室缩 (LVH) 发生率显著增加有关 (87%在RH+OSA和61%在RH-OSA,p=0.049).
- 后勤回归确定了RH,缩血压和OSA作为LVH的独立预测因素.
结论:
- 阻塞性睡眠呼吸暂停 (OSA) 独立地与左心室缩 (LVH) 相关,患者有抗性高血压 (RH).
- OSA可能在耐性高血压及其心血管并发症的预后中发挥重要作用.
- 需要进一步的研究来探索OSA在管理RH和预防HMOD方面的临床影响.
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