基于单线可穿戴心电图装置的社区老年高血压患者的OSA查和影响因素研究
Xinyan Yu1, Linger Guan2, Peng Su3
1The First People's Hospital of Yinchuan, Yinchuan, Ningxia Hui Autonomous Region, China.
Sleep & breathing = Schlaf & Atmung
|August 29, 2024
概括
单线心电图有效查老年高血压患者的阻塞性睡眠呼吸暂停 (OSA). 心脏异常,生活方式和健康指标是中度至重度OSA的关键风险因素.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 初级保健研究研究初级保健研究
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是一种普遍的疾病,在初级保健中经常被诊断不足,特别是在老年高血压患者中.
- 早期检测和风险分层对于管理OSA及其相关心血管并发症至关重要.
- 目前的查方法可能在成本,可访问性和可扩展性方面存在局限性,适用于大量人群.
研究的目的:
- 评估单线心电图 (ECG) 对大规模阻塞性睡眠呼吸暂停 (OSA) 查的有效性和成本效益.
- 在没有典型症状的老年高血压患者中,确定与中度至重度OSA相关的关键因素.
- 评估在初级保健机构使用可穿戴式心电图装置用于OSA检测的可行性.
主要方法:
- 数据来自中国宁夏15个医疗机构的2573名65岁以上高血压患者.
- 使用了72小时单线可穿戴心电图监测和ACAT算法进行OSA查.
- 使用多变量后勤回归和曲线下的面积 (AUC) 来识别风险因素并评估预测准确性.
主要成果:
- 观察到的整体OSA检测率为87.10%,其中55.42%的病例被归类为中度至重度.
- 中度至重度OSA的显著危险因素包括心脏不规则 (心室上部外,心室外),男性性别,酒精消费,吸烟,低SDNN (≤100 ms),异常的LF/HF比率,较高的BMI,以及年龄较大.
- 对OSA的预测模型表现出中度准确性,ROAUC为0.625.
结论:
- 单可穿戴心电图装置与ACAT算法相结合,为初级保健中OSA查提供了一种方便,低成本和可重复的方法.
- 这种方法通过识别高风险个体,促进了早期的OSA检测和管理.
- 了解相关的风险因素,如心脏不规则和生活方式选择,可以指导有针对性的干预措施,并改善患者的治疗结果.
相关概念视频
Special considerations while measuring blood pressure
710
When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
710
Electrocardiogram
2.2K
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
2.2K
Assessment of the Cardiovascular System I: Subjective Data
291
A thorough health history and physical assessment are essential for identifying cardiovascular disease (CVD) symptoms and distinguishing them from other health issues.
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
291
Factors affecting Blood pressure
3.0K
Several physiological and lifestyle factors influence blood pressure (BP). Understanding these factors is crucial as they are significant in patient education and blood pressure management.
Physiological Factors:
Physiological Factors:
3.0K
Errors occurring during blood pressure monitoring
621
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
621
Pre-Procedural Guidelines for Assessing Blood Pressure
526
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
526


