The Clinical Study Of 166 Patients With Hypertension And Obstructive Sleep Apnea-hypopnea Syndrome

Obiective: To explore the correlation between blood pressure rhythm,hypoxia degree and diabetes mellitus and target organ damage in patients with hypertension complicated with obstructive sleep apnea hypopnea syndrome,so as to provide reference for early prevention and treatment of target organ damage in patients with hypertension complicated with OSAHS.Methods: From October 2014 to January 2018,166 patients diagnosed with hypertension complicated by OSAHS during their stay in the first affiliated hospital of guangxi medical university were collected for subgroup analysis from blood pressure rhythm,degree of OSAHS,blood pressure grading,and whether they were complicated with diabetes.Results: 1.General information: There were 166 patients,including 154 males(92.8%),with an average age of 45.61±11.11 years.12 female patients(7.2%)with an average age of 63.75±13.97 years.Blood pressure level: 14 patients(8.4%)with grade 1 hypertension,28 patients(16.9%)with grade 2 hypertension,124 patients(74.7%)with grade 3 hypertension.Complicated with other diseases: 57 cases of metabolic syndrome(34.4%),13 cases of abnormal glucose tolerance and 35 cases of diabetes(28.9%),10 cases of coronary artery sclerosis(6.0%),and 7 cases of stroke(4.2%).2.Blood pressure rhythm distribution in 166 patients: 33.1% were dipper,51.8% were non-dipper and 15.2% were reverse dipper.Compared with dipper patients,not only the pulse wave conduction velocity(PWV),systolic blood pressure load(SBPL),creatinine(Cr),and 24 hours urinary protein(24h Upr),but also the 24-hour urine trace albumin(24h U-mAlb)and 24 h Upr median were significantly or higher than that in reverse dipper patients(all P<0.05).3.Compared with the mild OSAHS group,the high-density lipoprotein cholesterol(HDL-C)level in the moderate OSAHS group was significantly reduced(P<0.05),the median 24 h Upr of the severe OSAHS patients was significantly increased(P<0.05),and the mean heart rate of the severe OSAHS patients was significantly increased(P<0.05).4.Compared with non-diabetic patients with hypertension and OSAHS,the median of 24 h U-mAlb and 24 h Upr in patients with hypertension and OSAHS complicated with diabetes were significantly increased,HDL-C and endogenous creatinine clearance(Ccr)were reduced(all P<0.05).5.Multiple linear regression analysis showed that there was a significant positive correlation between age,fasting blood glucose(FBG)and all-day systolic blood pressure load(SBPL)and pulse wave conduction velocity(PWV),and a negative correlation between body mass index(BMI)and PWV.Conclusions: Patients with hypertension and OSAHS are often associated with metabolic syndrome,diabetes and other co-diseases,with significantly increased blood pressure and abnormal rhythm,which is more common in non-arytenoid type.Patients with antiarytenoid type have increased PWV,urine protein and average heart rate.The median BMI,24 h U-mAlb and 24 h Upr of patients with hypertension and OSAHS complicated with diabetes were significantly increased,while HDL-C and Ccr were decreased.Age,FBG and SBPL are positively correlated with PWV.The above results suggest that in patients with hypertension and OSAHS,the abnormal blood pressure rhythm and blood glucose,as well as the increased sympathetic nervous function with the clinical manifestations of increased heart rate,may be one of the mechanisms that promote the occurrence of atherosclerosis and microalbuminuria in the early stage.