Analysis of arrhythmia and blood pressure in male hypertension patients complicated with obstructive sleep apnea hypopnea syndrome

Zhou Qi; Yu Zhènqiu; Ji Qingwei

doi:10.3760/cma.j.issn.1673-4777.2016.08.010

Abstract：Objective To analyze the effect of obstructive sleep apnea hypopnea syndrome (OSAHS) on arrhythmia and blood pressure in patients with essential hypertension(EH).Methods Totally 282 male patients aged 30-60 with EH from October 2012 to January 2015 in Beijing Anzhen Hospital,Capital Medical University were randomly selected.All patients had polysomnography(PSG)and they were divided into 2 groups according to apnea hypopnea index(AHI):EH group(97 cases,AHI ＜ 5 times/h) and EH complicated with OSAHS group(EH + OSAHS group,185 cases,AHI≥5 times/h);the EH + OSAHS group included EH complicated with mild,moderate and severe OSAHS(EH + mild OSAHS,EH + moderate OSAHS and EH + severe OSAHS) respectively 82,45 and 58 cases.The occurrence of arrhythmia was observed and the dynamic electrocardiogram was recorded.Blood pressures were monitored by dynamic monitoring device in 24 h;the day average systolic blood pressure(DABPS),day average diastolic pressure(DABPD),night average systolic blood pressure(NABPS),night average diastolic blood pressure (NABPD) and blood pressure variability were recorded.Incidences of arrhythmia,levels and circadian rhythms of blood pressure were analyzed between groups.Results The incidence of arrhythmia in the EH + OSAHS group was significantly higher than that in the EH group [56.8％ (105/185) vs 22.7％(22/97),P ＜ 0.05];incidences of low risk arrhythmia and high risk arrhythmia in EH + moderate OSAHS and EH + severe OSAHS patients were all significantly higher than those in EH + mild OSANS patients [88.9％(40/45),89.7％ (52/58) vs 67.1％ (55/82);35.6％ (16/45),55.2％ (32/58) vs 12.2％ (10/82),P ＜0.05].Levels of DABPS,DABPD,NABPS,NABPD and the proportion of non-dipper blood pressure pattem in EH + OSAHS group were all significantly higher than those in EH group[(139 ± 16) mmHg vs (130 ± 12) mmHg,(88± 12) mmHg vs (81 ± 10) mmHg,(134 ± 17) mmHg vs (122 ± 12) mmHg,(83 ± 13) mmHg vs (75 ±10) mmHg,56.8％ (105/185) vs 27.8％ (27/97),P ＜ 0.05];in EH + severe OSAHS patients,levels of DABPD and NABPD were significantly higher than those in EH + mild OSAHS and EH + moderate OSAHS patients[(93 ± 9) mmHg vs (87 ± 11),(83 ± 12) mmHg;(90 ± 1 0) mmHg vs (81 ± 13),(77 ± 11) mmHg];the level of NABPS and the proportion of non-dipper blood pressure pattern were significantly higher than those in EH + mild OSAHS patients[(138 ± 18) mmHg vs (130 ± 16) mmHg,81.0％ (47/58) vs 36.6％ (30/82),P ＜ 0.05].Conclusion The incidence of arrhythmia and the level of blood pressure increase with OSAHS severity in hypertension patients complicated with OSAHS.