The Clinical Epidemiological Study Of Obstructive Sleep Apnea Hypopnea Syndrome Complicated With Hypertension

Objective: â‘  To investigate the prevalence of hypertension among obstructive sleep apnea hypopnea syndrome patients and compare it with the normal subjects. â‘¡To assess whether obstructive sleep apnea hypopnea syndrome is an independent factor for hypertension after controlled for confounding factors (such as age, sex, BMI, drink, smoke et, al).â‘¢To analysis the variability of blood pressure of obstructive sleep apnea hypopnea syndrome patients and its significantly related factors. â‘£To explore the relationship between apnea events (with the state of oxygeon saturation) and the hypertension.Methods: The epidemiology investigation of this study is ancross-sectional study and adopt case-control study. 775 cases all chose from the general hospital outpatient sleep clinical of Tian Jin Medical University. The control subjects were selected from the general hospital outpatient and physicial examination population. All subjects write the same sleep questionnaire and accept the simple physicial examination. All of the cases and some of the controls performed the nocturnal polysomnography and measure the blood pressure before subjects go to bed and in the next morning when he was awake.Results: â‘ The prevalence of hypertension in the obstructive sleep apneahypopnea syndrome patients is 46. 8%, and the prevalence of hypertension is 23.3% in the controlled subjects. â‘¡ The prevalence of hypertension between obstructive sleep apnea hypopnea syndrome patients is significantly higher than control subjects. After put the subjects intodifferent groups according to age, BMI and sex, this differences of prevalence also has statistical significance. The prevalence of hypertension also increased with the extent of the illness. ?The results of Logistic regression analysis point out that the important parameter of obstructive sleep apnea hypopnea syndrome (AHI and the lowest oxygeon saturation in the night)is dangerous factor for hypertension and has a dose response with the odds ratio for hypertension .Further analysis show that AHI and the lowest oxygeon saturation in the night are the independent factors of hypertension afer control for age, sex, BMI, drink, smoke, et, al. In the younger subjects?50y) the odds ratio for hypertension , comparing the highest categories of AHI with the lowest categories, is also higher and has statistical significance. ?Patients with obstructive sleep apnea hypopnea syndrome syndrome has significantly increased diastolic pressure and systolic pressure during morning in the next day than before go to bed . The magnitude of the variability increased with the extent of patients' illness. AHI and the lowest oxygeon saturation in the night are related to diastolic pressure and systolic pressure, after adjusted for age, sex and BMI. ? Obstructive sleep apnea syndrome patients with hypertension compared with those without Obstructive sleep apnea syndrome patients without hypertension , there are no significantly difference about the mean oxygeon saturation in the night, but the apnea parameters (AHI, AT/ST) and desaturation parameters(0DI4, SLT90) are significantly increased in the obstructive sleep apnea syndrome patients with hypertension. The lowest oxygeon saturation also decreased significantly in the obstructive sleepapnea syndrome patients with hypertension.Conclusion: The prevalence of hypertension in obstructive sleep apneahypopnea syndrome patients is significantly higher than those without obstructive sleep apnea hypopnea syndrome patients. Obstructive sleep apnea hypopnea syndrome is an independent factors for hypertension after control for the confounding factors. The variability of blood pressure in obstructive sleep apnea hypopnea syndrome patients have significantly difference compare with the control group. AHI and the lowest oxygeon saturation can independently forecast the increasing blood pressure in the morning. Hypoxemia, arousal and pleural pressure chang largely result from apnea maybe the etiology of obstructive sleep apnea syndrome complicate with hypertension.