Falls in blood pressure in patients with obstructive sleep apnoea after long-term nasal continuous positive airway pressure treatment
Falls in blood pressure in patients with obstructive sleep apnoea after long-term nasal continuous positive airway pressure treatment
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DOI：
10.1097/01.hjh.0000244960.69985.4c
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发表时间：
2006-10-01
影响因子：
4.9
通讯作者：
Nakamura, Takashi
中科院分区：
文献类型：
--
作者：
Chin, Kazuo;Nakamura, Takaya;Nakamura, Takashi
目的鼻持续气道正压通气（nCPAP）治疗阻塞性睡眠呼吸暂停（OSA）有效。nCPAP治疗对OSA患者血压的长期影响尚不清楚。这种治疗的时间足以降低OSA患者的血压也不清楚。我们调查了长期nCPAP治疗的依从性及其对血压的影响。方法本观察性研究纳入66例OSA患者[男性59例，女性7例；平均年龄51岁（48-54岁）；身体质量指数（BMI） 28.7 (27.7-29.7) kg/m(2)；呼吸暂停和呼吸不足分别为50.3 (45.6 ~ 55.0)/h；95%置信区间]。在研究前和使用nCPAP后的两个检查点分别测量血压和BMI[620（552-688）天和1071（1000-1143）天]。结果第1、2个客观依从性检查点的时间差异为17 (4 ~ 30)min （P = 0.003）。nCPAP治疗600天后舒张压降低5.9 (3.1-8.7)mmHg， 1000天后降低4.6 (2.0-7.2)mmHg （P = 0.0006）。收缩压和BMI无明显变化。平均每天使用3小时的nCPAP治疗可显著降低舒张压[7.4 (4.3-10.6)mmHg, P < 0.0001]。正常OSA患者的舒张压在nCPAP治疗后无明显变化，而高血压OSA患者的舒张压在nCPAP治疗后1个月-3年内不论是否用药均有明显下降。结论在重度OSA患者中，平均每天使用3小时的nCPAP足以降低高血压性OSA患者的舒张压。
Objectives Effective treatment of obstructive sleep apnoea (OSA) with nasal continuous positive airway pressure (nCPAP) lowers blood pressure (BP). The long-term effects of nCPAP treatment on BP in OSA patients are not well known. The time period of such treatment sufficient to lower BP in OSA patients is also not known. We investigated compliance with long-term nCPAP therapy and its effects on BP.Methods This observational study involved 66 OSA patients [59 men, seven women; mean age, 51 (48-54) years; body mass index (BMI), 28.7 (27.7-29.7) kg/m(2); apnoea and hypopnoea, 50.3 (45.6-55.0)/h; 95% confidence intervals]. BP and BMI were measured before the study and at two checkpoints after usage of nCPAP [620 (552-688) and 1071 (1000-1143) days].Results The different times between the first and second checkpoints for detecting objective compliance were 17 (4-30) min (P = 0.003). Diastolic BP decreased by 5.9 (3.1-8.7) mmHg after 600 days nCPAP treatment and by 4.6 (2.0-7.2) mmHg after 1000 days (P = 0.0006). Systolic BP and BMI did not change significantly. Usage of nCPAP treatment for a daily average of 3 h was needed to achieve a significant decrease in diastolic BP [7.4 (4.3-10.6) mmHg, P < 0.0001]. Diastolic BP of normotensive OSA patient did not change significantly by nCPAP treatment, but that of hypertensive OSA patients decreased significantly within 1 month-3 years of nCPAP treatment whether or not medication was used.Conclusions In patients with severe OSA, the use of nCPAP for a daily average of 3 h would be sufficient to decrease the diastolic BP of hypertensive OSA patients.