Effect Of Different Non-invasive Ventilation Modes On Blood Pressure Fluctuation In Patients With Obstructive Sleep Apnea Hypopnea Syndrome Combined With Hypertension

Objective:1.To investigate the effect of auto-continuous positive airway pressure on nocturnal blood pressure fluctuation in patients with obstructive sleep apnea hypopnea syndrome combined with hypertension.2.To investigate the effect of continuous positive airway pressure on nocturnal blood pressure fluctuation in patients with obstructive sleep apnea hypopnea syndrome combined with hypertension.3.To compare the effects of auto-continuous positive airway pressure and continuous positive airway pressure on nocturnal blood pressure fluctuations in patients with obstructive sleep apnea hypopnea syndrome combined with hypertension.Method:Seventy-three patients with obstructive sleep apnea hypopnea syndrome combined with hypertension who were diagnosed by polysomnography in the respiratory department of Karamay Central Hospital and Han Dan Central Hospital between January 2022 and December 2022 were selected as the study objects.On the basis of maintaining the original antihypertensive drug treatment,73 patients were treated with auto-continuous positive airway pressure and continuous positive airway pressure.Pulse transit time method was used to conduct continuous ambulate blood pressure monitoring,and nocturnal systolic blood pressure fluctuation index and nighttime systolic blood pressure standard deviation were used to quantify blood pressure fluctuation.The changes of nighttime mean systolic/diastolic blood pressure,the standard deviation of nighttime systolic/diastolic blood pressure and nocturnal systolic blood pressure fluctuation index were observed under two non-invasive ventilation modes.Results:1.A total of 73 patients with obstructive sleep apnea hypopnea syndrome combined with hypertension were included in this study,including 51 males and 22 females.The mean age was(54.58±11.95)years.The mean body mass index was(30.40±5.00)kg/m~2.And the mean sleep apnea hypopnea index was(45.22±23.08)times per hour.2.There was significant decrease in the nocturnal systolic blood pressure fluctuation index compared with baseline level during the first night of auto-continuous positive airway pressure and the difference was statistically significant(P<0.05).There was no significant decrease in the nighttime mean systolic/diastolic blood pressure and the standard deviation of nighttime systolic/diastolic blood pressure compared with baseline level during the first night of auto-continuous positive airway pressure(P>0.05).3.There was significant decrease in the nocturnal systolic blood pressure fluctuation index and the standard deviation of nighttime systolic blood pressure compared with baseline level during the first night of continuous positive airway pressure and the difference was statistically significant(P<0.05).There was no significant decrease in the nighttime mean systolic/diastolic blood pressure and the standard deviation of nighttime diastolic blood pressure compared with baseline level during the first night of continuous positive airway pressure(P>0.05).4.There was a statistical difference in the reduction of nocturnal systolic blood pressure fluctuation index between the first night of auto-continuous positive airway pressure and the first night of continuous positive airway pressure treatment(P<0.05).Compared with auto-continuous positive airway pressure treatment,continuous positive airway pressure treatment resulted in a more significant reduction in nocturnal systolic blood pressure fluctuation index.However,there were no significant differences in the nighttime mean systolic/diastolic blood pressure and the standard deviation of nighttime systolic/diastolic blood pressure between the two noninvasive ventilation modes(P>0.05).Conclusion:1.Both short-term auto-continuous positive airway pressure treatment and continuous positive airway pressure treatment can improve nocturnal blood pressure fluctuation in patients with obstructive sleep apnea hypopnea syndrome combined with hypertension.2.Continuous positive airway pressure therapy improved blood pressure fluctuation at night more significantly than auto-continuous positive airway pressure therapy.3.In patients with obstructive sleep apnea hypopnea syndrome and hypertension who take antihypertensive drugs regularly,short-term auto-continuous positive airway pressure treatment and continuous positive airway pressure treatment do not significantly reduce nocturnal blood pressure.