Clinical Observation Of Young, Middle And Old Aged Patients With Hypertension And Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS)

Objective:To discuss the clinical features of young, middle and old aged patients with essential hypertension and OSAHS. Methods:The retrospective analysis was conducted on the clinical data of353patients with essential hypertension and OSAHS diagnosed by the Hypertension Department of the First Teaching Hospital of Xinjiang Medical University from January2011to July2013. The patients were divided into young group (136patients) and the middle and old aged group (217patients) by age and then the differences of general clinical data, sleep apnea monitoring indexes,24-hour ambulatory blood pressure, renin-angiotensin-aldosterone system activity between the young group and the middle and old aged group were analyzed. Results:(1) The differences of sex composition ratio, drinking composition ratio, fasting blood-glucose (FBG), triacylglycerol (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and lipoprotein a (LPa) of the young group and middle and old aged group are not statistically significant (P>0.05); the smoking composition ratio and body mass index (BMI) of the young group are higher than that of the middle and old aged group and the high-density lipoprotein cholesterol (HDL-C) of the young group is lower than that of the middle and old aged group, and the differences are statistically significant (P＜0.05);(2) the apnea hypopnea index (AHI) and time of oxyhemoglobin saturation of less than85%(TS<85%) of the middle and old aged group are higher than that of the young group and the mean oxygen saturation (MSaO2) and the lowest oxygen saturation (LSaO2) of the middle and old aged group are lower than that of the young group, the differences between the two groups are statistically significant (P＜0.05);(3) the24-hour mean systolic blood pressure (24hSBP) and24-hour mean diastolic blood pressure (24hDBP) of the young group are higher than those of the middle and old aged group and the hypertension course of the middle and old aged group is longer than that of the young group, the differences are statistically significant (P<0.05); the difference of the24-hour mean pulse pressure between the young group and the middle and old aged group is not statistically significant(P>0.05);(4)the levels of angiotensin A1and A2of the young group in supine and standing is higher than that of the middle and old aged group and the level of aldosterone of the young group in supine is lower than that of the middle and old aged group, the differences are statistically significant (P＜0.05); and there is no difference of the levels of aldosterone in standing between the two groups (P>0.05). ConclusioniDuring the preventive treatment of the young, middle and old aged patients with hypertension and OSAHS, attentions should be paid to quitting smoking, losing weight, reducing the angiotensin activity and strengthening the depressurization efforts for the young patients; attentions should be paid to reducing the aldosterone activity and adopting non-invasive positive airway pressure to modify the disease for the middle and old aged patients.