在患有阻塞性睡眠呼吸暂停的老年患者中影响新发高血压的因素:一个多中心队列研究
LiBo Zhao1, YingHui Gao2, WeiHao Xu3
1Cardiology Department of the Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
Clinical and translational science
|November 16, 2023
概括
患有阻塞性睡眠呼吸暂停 (OSA) 的老年患者面临因年龄,高呼吸暂停-呼吸暂停指数 (AHI) 和血红蛋白 (Hb) 水平而增加的高血压风险. 持续的正气道压力 (CPAP) 可以减轻这种风险.
科学领域:
- 老年学是指老年学的学科.
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 在老年人中很普遍,并与心血管并发症有关.
- 高血压是老年人群的重大健康问题,其与OSA的关系需要进一步调查.
- 了解老年OSA患者新发高血压的特定风险因素对于有针对性的预防策略至关重要.
研究的目的:
- 确定影响老年患者新发高血压发展的关键因素,诊断为阻塞性睡眠呼吸暂停.
- 评估持续正气道压力 (CPAP) 治疗对该人口中高血压发病率的潜在保护作用.
- 探索子组特定的风险因素,例如与代谢健康和睡眠参数相关的风险因素.
主要方法:
- 一项多中心研究招募了450名非高血压的中国老年患者,这些老年患者患有OSA,并接受了多睡眠学.
- 卡普兰-梅尔生存分析和多变量考克斯比例危险模型被用来确定发生高血压的预测因素.
- 随访时间平均为33个月,以记录高血压的发展.
主要成果:
- 在随访期间,共有176名 (39.1%) 患者患上高血压.
- 新发性高血压的独立预测因素包括年龄较大,血红蛋白 (Hb) 水平较高和呼吸暂停-呼吸暂停指数 (AHI) 较高.
- 持续的气道正压 (CPAP) 治疗与患高血压的风险降低有关 (HR=0.508). 亚组分析显示了血葡萄糖,BMI,脂质失调以及氧和率低于90% (Tsat90) 的时间作为显著因素.
结论:
- 年龄,AHI和Hb水平是老年OSA患者新发高血压的重要独立预测因素.
- 在这个群体中,CPAP疗法显示出对高血压发展的保护作用.
- 针对BMI,脂质失调和血糖控制等因素的有针对性的干预措施,特别是在特定的亚组中,可能有效地预防高血压.
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