Exploration of the pathogenesis of hypertension caused by obstructive sleep apnea hypopnea syndrome
10.3969/j.issn.1008-0074.2017.05.05
- VernacularTitle:阻塞性睡眠呼吸暂停低通气综合征致高血压机制探索
- Author:
Qian WANG
1
;
wen Xin MIN
;
feng Dong LI
;
jian Ming LANG
Author Information
1. 湖北医药学院附属东风医院心血管内科
- Keywords:
Sleep apnea;
obstructive;
Continuous positive airway pressure;
Hypertension
- From:
Chinese Journal of cardiovascular Rehabilitation Medicine
2017;26(5):478-482
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the role of sympathetic adrenal medulla system,vascular endothelial function and renin-angiotensin-aldosterone system (RAAS)in the pathogenesis of hypertension caused by obstructive sleep apnea hypopnea syndrome (OSAHS).Methods:A total of 42 OSAHS patients with hypertension (OSAHS + hypertension group)were selected,and they received continuous positive airway pressure (CPAP)treatment for six months.An-other 50 OSAHS patients without hypertension and no received CPAP treatment were regarded as pure OSAHS group.Levels of norepinephrine (NE),24h urine vanillyl mandalic acid (VMA),nitric oxide (NO),endothelin-1 (ET-1),angiotensin Ⅱ (AngII)and aldosterone before and after treatment were compared in OSAHS + hyperten-sion group,and they were compared with those of pure OSAHS group.Results:① Compared with pure OSAHS group and before treatment in OSAHS + hypertension group,there were significant rise in levels of NE [(3.0± 1.4)ng/ml vs.(4.1± 1.7)ng/ml,(3.7 ± 1.5)ng/ml],ET-1 [(56.7 ± 12.6)pg/ml vs.(66.3 ± 14.7)pg/ml, (63.2±13.8)pg/ml],AngⅡ [(38.2±6.7)pg/ml vs.(45.7±8.5)pg/ml,(42.1 ±7.6)pg/ml]and aldosterone [(148±12)ng/L vs.(162±16)ng/L,(154±15)ng/L],and significant reduction in NO level [(63.7±11.8)μmol/L vs.(56.2 ±8.4)μmol/L,(59.1 ±9.3)μmol/L]after treatment in OSAHS + hypertension group,P <0.05 or <0.01,but there was no significant difference in 24h urine VMA level,P >0.05 both;②Compared with before treatment,there were significant reductions in levels of NE,ET-1 and AngII after treatment in OSAHS +hypertension group (P <0.05 or <0.01),but there were no significant difference in levels of 24h urine VMA,NO and aldosterone,P >0.05 all.Conclusion:Sympathetic adrenal medulla system,renin-angiotensin-aldosterone sys-tem and vascular endothelial function may be involved in incidence of hypertension in OSAHS patients.
