Effect of continuous positive airway pressure (CPAP) therapy on heart rhythm and blood pressure variability in primary hypertensive patients with obstructive sleep apnea/hypopnea syndrome (OSAHS)
10.3760/cma.j.issn.1671-7368.2015.08.008
- VernacularTitle:经鼻持续气道内正压通气对阻塞性睡眠呼吸暂停低通气综合征伴原发性高血压患者心率和血压的影响
- Author:
Jianwei LUO
;
Li ZENG
;
Haibo XU
- Publication Type:Journal Article
- Keywords:
Sleep apnea,obstructive;
Continuos positive airway pressure;
Hypertension
- From:
Chinese Journal of General Practitioners
2015;14(8):603-606
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of continuous positive airway pressure therapy (CPAP) on heart rhythm and blood pressure variability in primary hypertensive patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).Methods Ninety seven patients with OSAHS and primary hypertension were randomly divided into treatment group (n =49) and control group (n =48).Patients in control group receive antihypertensive medication only,while patients in treatment group received antihypertensive medication in combination with CPAP therapy for 4 weeks.The dynamic electrocardiogram (ESG) and ambulatory blood pressure for 24 h were measured before and after treatment in both groups.Results After CPAP treatment,the night index of standard deviation of the average NN intervals (SDANNniGHt) in treatment group was (89.0 ± 21.4) ms,while the day and night index of square root of the mean squared differences of successive NN intervals (rMSSDday and rMSSDnight) was (35.9 ± 17.2) ms and (45.7 ± 18.3) ms respectively.Compared with those before treatment,the index of SDANNnight was decreased and the indexes of rMSSDday and rMSSDnight were increased (P ＜ 0.01).Compared with control group,the SDANNnight was decreased,and the rMSSDday and rMSSDnight were increased (P ＜ 0.01,P ＜ 0.05).After CPAP treatment,the night index of low-frequency power (LFnight) in treatment group was (15.3 ± 5.7) ms,which was lower than that before treatment,and the night index of high-frequency power (HFnigh) was (16.3-± 8.1)ms,which was higher than that before treatment (P ＜ 0.01);the LFnight in treatment group was decreased and the HFnight was increased (P ＜ 0.01).After CPAP treatment,the day and night indexes of systolic blood pressure (SBPday and SBPnight) and the night indexes of diastolic blood pressure (DBPnigh) t in treatment group were (136.1 ± 13.4) mmHg,(128.7 ± 9.8) mmHg (1 mmHg =0.133 kPa),and(83.7 ±7.2)mmHg respectivley,which were all lower than those in control group (P ＜ 0.05 or P ＜ 0.01).The incidences of morning peak blood pressure and non-dipper hypertension in control group were significantly higher than those in treatment group (P ＜ 0.01).Conclusion CPAP therapy can effectively adjust the heart rate and blood pressure levels in patients with OSAHS and primary hypertension,especially in the night.
