The Effect Of NCPAP Treatment On The Blood Pressure And BNP In Hypertensives Complicated With OSAHS And EMBPS

Object:As Early Morning Blood Pressure Surge(EMBPS)plays an important role in the occurrence of cardio-cerebral vascular disease,the control of EMBPS is becoming a new therapeutic target.Hypertension ties in closely with Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS),while relationship between EMBPS and OSAHS has rarely been studied.Likewise,the Brain Natriuretic Peptide(BNP)takes part in the regulation of blood pressure and body fluid,but the correlation of BNP and EMBPS has hardly been reported either.In this research,we have used nasal Continuous Positive Airway Pressure(nCPAP)on hypertensives complicated with moderate or severe OSAHS and EMBPS to investigate the effect on EMBPS and BNP.We look forward to discuss the possible association between OASHS and EMBPS,and provide certain reference for the clinical diagnosis and treatment.Method:Based on the result of polysomnography(PSG)and 24 hour Ambulatory Blood Pressure Monitoring(ABPM),34 hypertensives complicated with moderate or severe OSAHS and EMBPS were involved. They were divided into treatment group of 20 cases and control group of 14 cases.The serum level of BNP was detected in the morning after waking by Enzyme-Linked Immunosorbnent Assay(ELASA).And we calculated the average systolic blood pressure(AvSP),average diastolic blood pressure(AvDP)and mean arterial blood pressure(MABP)of the morning blood pressure,the lowest sleep blood pressure and the EMBPS. The treatment group received 5 days of nCPAP treatment,but the control group didn't.Both groups were examined by ABPM on the fifth day and the serum level of BNP was detected on the sixth morning.The difference between the treatment group and the control group was analyzed.Result:1.The AvSP and MABP of the EMBPS,and the AvSP,AvDP and MABP of the morning blood pressure declined remarkably in the treatment group after being treated(p＜0.05).But the control group didn't(p＞0.05).2.The AvSP,AvDP and MABP of the lowest sleep blood pressure in both groups didn't change obviously(p＞0.05).3.The serum level of BNP in the treatment group showed a pronounced drop after treatment(p＜0.05).But the control group didn't(p＞0.05).And there was a significant positive correlation between the equation of BNP and the equation of AvSP of the morning pressure before and after the treatment(r=0.540,p＜0.05).Conclusion: 1.nCPAP therapy lowered the degree of EMBPS in hypertensives complicated with moderate or severe OSAHS and EMBPS.It seemed that OSAHS may contribute to EMBPS.2.nCPAP therapy lowered the serum level of BNP in hypertensives complicated with moderate or severe OSAHS and EMBPS in the morning. BNP may take part in the regulation of EMBPS.