在所有中度至重度阻塞性睡眠呼吸暂停患者中,是否必须进行24小时的ABPM?
Edgar D Osuna1,2, Adrián C Zamora1, Andrés F Buitrago3
1Department of Neurology, Fundación Santafé de Bogotá, Bogotá, Colombia.
Sleep science (Sao Paulo, Brazil)
|July 10, 2023
概括
阻塞性睡眠呼吸暂停 (OSA) 与高血压有关,但与不下降的血压模式不一致,特别是在高空. 患有严重OSA的老年人和吸烟者分别面临高血压和非浸泡模式的更高风险.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 睡眠医学 睡眠医学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是动脉高血压 (HT) 的潜在危险因素.
- OSA和夜间血压不下降 (ND) 模式之间的联系是可变的,并且缺乏来自高海拔群体的数据.
- 这项研究调查了居住在高海拔地区的个体的OSA,HT和ND模式.
研究的目的:
- 确定中度至重度OSA与HT和ND模式的流行率和相关性.
- 在高海拔地区的高血压和非高血压个体中识别HT和ND模式的预测因素.
主要方法:
- 患有中度至重度OSA的成年人接受了24小时的门诊血压监测 (ABPM).
- 使用了单变量和多变量逻辑回归分析.
- 在2015-2017年期间在波哥大 (海拔2640米) 进行的研究.
主要成果:
- 分析了93名参与者 (62.4%是男性,平均年龄为55岁).
- 30.1%的人表现出ND模式;14.9%的人有白天和夜间高血压.
- 严重的OSA (较高的呼吸暂停-呼吸暂停指数[AHI]) 与HT相关 (p=0.006),但没有ND (p=0.54).
- 吸烟和最低氧和独立预测ND (p=0.04);年龄预测HT (p=0.001).
结论:
- 三分之一的中度至重度OSA患者表现出ND模式,表明没有直接关联.
- 较高AHI的老年人更容易患HT;吸烟者患ND的风险增加.
- 调查结果质疑在资源有限的高海拔地区24小时ABPM的常规使用,需要进一步研究.
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