The Prevalence and Clinical Features of Hypertension in Patients With Obstructive Sleep Apnea Hypopnea Syndrome and Related Nursing Strategies

Yan Wang; Qing-Chan Yang; Jing Feng; Jie Cao; Bao-Yuan Chen

doi:10.1097/jnr.0000000000000111

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P41 - 47

医药卫生 > 预防保健与卫生学
医药卫生 > 社会医学

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The Prevalence and Clinical Features of Hypertension in Patients With Obstructive Sleep Apnea Hypopnea Syndrome and Related Nursing Strategies

阻塞性睡眠呼吸暂时低通气综合征患者高血压的患病率、临床特点及其护理对策

王彦(Yan Wang) ；杨庆婵(Qing-Chan Yang) ；冯靖(Jing Feng) ；曹洁(Jie Cao) ；陈宝元(Bao-Yuan Chen)

The Journal of Nursing Research ； 24 卷 1 期 (2016 / 03 / 01) ， P41 - 47

英文 DOI： 10.1097/jnr.0000000000000111

阻塞性睡眠呼吸暂停低通气综合征；高血压；昼夜节律；呼吸暂停低通气指数；护理； obstructive sleep apnea hypopnea syndrome ； hypertension ； circadian variation ； apnea-hypopnea index (AHI) ； nursing

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摘要 │ 参考文献 (26) │ 国际计量

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Background: Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common sleep-related breathing disorder. Hypertension is frequently a concomitant disorder in patients with OSAHS. Purpose: This study investigates the prevalence and clinical features of hypertension in patients with OSAHS and explores the related nursing strategies. Methods: Three thousand six hundred seven patients were included in this study. Subjects were divided into four groups that were categorized according to apnea-hypopnea index (AHI) scores as follows: control group (control, n = 354) with AHI G 5, mild OSAHS (mild, n = 658) with 5 e AHI G 15, moderate OSAHS (moderate, n = 753) with 15 e AHI G 30, and severe OSAHS (severe, n = 1842) with AHI Q 30. Blood pressure (BP) values were measured at four time points (daytime, evening, nighttime, and morning). The prevalence of hypertension and BP values in the different groups were compared at four time points. Finally, the nighttime-to-daytime mean BP (MBP;R_(N/D)) and morning-to-evening MBP (R_(M/E)) ratios were calculated. Results: The prevalence of hypertension in the control group, mild group, moderate group, and severe group were 22.32%, 34.65%, 39.04%, and 55.37%, respectively. AHI positively correlated with the prevalence of hypertension (r = .191, p G .001). The daytime, nighttime, evening, and morning MBP rose as AHI increased. The ratios of nighttime-to-daytime MBP (R_(N/D)) and morning-to-evening MBP (R_(M/E)) increase with the severity of the illness (F = 9.821 and 18.957; p G .001). The daytime BP correlates significantly with AHI and lowest oxygen saturation (LSaO_2; systolic BP, r = .195 and j.206; diastolic BP, rs = .248 and j.251, p G .01). Daytime MBP increases gradually in small fluctuations concurrent with increases in AHI until 61Y65. Conclusions/Implications for Practice: OSAHS is an independent risk factor for hypertension. Patients with OSAHS have a significant increase in nighttime and morning BP, which means they lose normal BP diurnal rhythm. Therefore, nurses should take necessary measures based on the clinical features of hypertension in patients with OSAHS to minimize the risk of cardiocerebral vascular incidents.

参考文献 ( 26 ) 〈TOP〉

Almirall, J.,Comas, L.,Martínez-Ocaña, J. C.,Roca, S.,Arnau, A.(2012).Effects of chronotherapy on blood pressure control in non-dipper patients with refractory hypertension.Nephrology Dialysis Transplantation,27(5),1855-1859.
Belaidi, E.,Joyeux-Faure, M.,Ribuot, C.,Launois, S. H.,Levy, P.,Godin-Ribuot, D.(2009).Major role for hypoxia inducible factor-1 and the endothelin system in promotingmyocardial infarction and hypertension in an animalmodel of obstructive sleep apnea.Journal of the AmericanCollege of Cardiology,53(15),1309-1317.
Bosc, L.V.,Resta, T.,Walker, B.,Kanagy, N. L.(2010).Mechanisms of intermittent hypoxia induced hypertension.Journal of Cellular and Molecular Medicine,14(1-2),3-17.
Calhoun, D. A.,Jones, D.,Textor, S.,Goff, D. C.,Murphy, T. P.,Toto, R. D.,American Heart Association Professional Education Committee(2008).Resistant hypertension: Diagnosis, evaluation, and treatment: A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research.Circulation,117(25),e510-e526.
Cheng,M.,Cheng, S. L.,Zhang, Q.,Jiang, H.,Cong, J. Y.,Zang, X. Y.,Zhao, Y.(2014).The effect of continuous nursing intervention guided by chronotherapeutics on ambulatory blood pressure of older hypertensive patients in the community.Journal of Clinical Nursing,23(15-16),2247-2254.

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