在阻塞性睡眠呼吸暂停的不同严重程度上,CPAP对血压参数的影响:元分析
Lara Benning1, Joël J Herzig1, Michelle S Mollet1
1Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland.
Journal of sleep research
|April 20, 2025
概括
持续正气道压力 (CPAP) 在阻塞性睡眠呼吸暂停 (OSA) 患者的血压略有降低. 这种效应在严重的OSA和更长时间的夜间CPAP使用中更为明显,特别是在夜间血压上.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 肺部病理学 肺部病理学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 与心血管问题有关,包括高血压.
- 持续正气道压力 (CPAP) 是OSA的主要治疗方法,已知但对血压 (BP) 有适度的影响.
- CPAP对血压的影响可能因OSA的严重程度和患者的坚持而有所不同.
研究的目的:
- 为了研究CPAP在阻塞性睡眠呼吸暂停不同严重程度的血压上的差异性影响.
- 确定影响CPAP降血压功效的诸如OSA严重程度和CPAP使用时间等因素.
主要方法:
- 随机对照试验 (RCT) 的系统性审查和随机效应元分析,将CPAP与OSA患者的非活性对照进行比较.
- 搜索Medline到2023年12月的RCT评估办公室,24小时,白天和夜间的缩和腹缩血压.
- 采用元回归和子组分析来探索OSA特征和CPAP使用对降低血压的影响.
主要成果:
- 包括75个RCT,包括10,025名患者;CPAP在所有测量 (办公室,24小时,白天,夜间) 中显示了缩血压的适度降低.
- 较大的血压降低与更高的基线24小时和白天SBP以及更长的夜间CPAP使用 (≥5小时/晚).
- 在患有严重的OSA (呼吸暂停-呼吸暂停指数≥30/h) 和使用CPAP较长时间的患者中,降血压的影响更为显著.
结论:
- 在OSA患者中,CPAP疗法有效降低血压,对夜间BP的影响更大.
- 血压降低的程度受到OSA严重程度和患者遵守CPAP治疗 (≥5小时/晚) 的影响.
- 这些发现强调了夜间血压控制和有效CPAP使用在管理OSA相关高血压方面的预后重要性.
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