Effect Of Uvulopalatopharyngoplasty On Blood Pressure Rhythm In OSAHS Patients With Hypertension

ObjectiveTo investigate the effect of obstructive sleep apnea hypopnea syndrome on blood pressure circadian rhythm of patients with hypertension,and to explore the feasibility of uvulopalatopharyngoplasty to improve blood pressure circadian rhythm of patients.Objects and methodsA prospective study was conducted on patients diagnosed with OSAHS complicated with hypertension in the otorhinolaryngology Department of Hefei Second People’s Hospital from January 2020 to August 2021.Basic information of the patients was collected,including gender,age,height and weight,and Body Mass Index was calculated.Patients were asked about their past disease history,smoking,hypertension course and medication.Epworth sleepiness Scale score was improved,and surgical treatment was scheduled.Polysomnography and 24-hour ambulatory-blood pressure were performed preoperatively and 6 months postoperatively.Apnea hypopnea index,MSp O₂,LSp O₂,24h SBP,24h DBP,d SBP,d DBP,n SBP,n DBP and nocturnal blood pressure drop rate were recorded.SPSS26.0 software was used for statistical analysis of the data,and the preoperative and postoperative sleep respiratory parameters and blood pressure values were compared.Result1.There were 41 OSAHS patients with hypertension,including 32 males and 9females.Their ages ranged from 19 to 66 years old,with an average age of42.98±11.16 years old.BMI:21.71～38.42kg/m~2,average BMI:28.45±4.04kg/m~2,including 9 smokers,21 with hyperlipidemia and 7 with diabetes.2.After treatment,AHI was significantly decreased,MSp O₂ and LSp O₂ were significantly increased,and the differences were statistically significant compared with before treatment（P<0.05）.3.24h SBP,24h DBP,d SBP,n SBP and n DBP were significantly decreased after treatment（P<0.05）.d DBP decreased slightly after treatment（P>0.05）.The nocturnal drop rate of systolic blood pressure and diastolic blood pressure increased（P<0.05）.After treatment,19 patients（46.34%）with normal circadian rhythm of blood pressure increased compared with 4 patients（9.76%）before treatment（P<0.05）.4.A total of 17 patients（41.45%）reduced the use of antihypertensive drugs after surgery,and the difference was statistically significant compared with before treatment（P<0.05）.5.There was a significant positive correlation between the decreasing value of AHI and the decreasing rate of systolic blood pressure at night,the increasing value of MSp O₂ and the decreasing rate of systolic blood pressure at night（P<0.05）.ConclusionOSAHS affects the circadian rhythm of blood pressure in hypertensive patients,and uvulopalatopharyngoplasty can increase MSp O₂,decrease AHI and blood pressure.With the decrease of AHI and increase of MSp O₂,the circadian rhythm of blood pressure was improved.