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目的调查我国睡眠呼吸暂停人群高血压患病情况和影响因素。方法纳入2004至2006年全国20家三甲医院呼吸内科门诊就诊的2297例患者,男:女为1310:211,均经过询问病史、体格检查和多导睡眠监测。统一使用中华医学会呼吸病学分会睡眠呼吸疾病学组编制的《睡眠呼吸暂停与高血压发病情况问卷调查表》对受试者进行问卷和规范的血压测量。应用 SPSS 11.0软件包进行数据分析,采用 X~2检验比较高血压患病率。结果呼吸暂停低通气指数(AHI)<5次/h 组(213例)的高血压患病率(23.5%)明显低于 AHI≥5次/h 组(2084例)的高血压患病率(49.3%);阻塞性睡眠呼吸暂停低通气综合征(OSAHS)人群的高血压患病率为56.2%(569/1012);有高血压家族史人群的高血压患病率为63.7%(450/706),明显高于无家族史者39.4%(627/1591)的患病率;AHI≥5次/h 组的高血压患病几率是 AHI<5次/h 组的3倍(OR=3.167,95%CI 为2.953～5.426,P<0.01);受试人群的高血压患病率随 AHI 增加而增加,自 AHI 16～20次/h 起患病率增高幅度明显加大,AHI 66～70次/h 以后呈下降趋势。经计算得出公式:高血压患病率=0.3199+0.0042×AHI;高血压患病的 OR 值=1.018+0.017×AHI,同时,受试者的高血压患病率随睡眠最低血氧饱和度的减低而明显增高,随嗜睡指数增高而明显增高。受试人群的 AHI 为独立于年龄、性别、体重指数和高血压家族史之外的高血压危险因素。结论睡眠呼吸暂停人群的高血压患病率明显高于无睡眠呼吸暂停人群,睡眠呼吸暂停与高血压患病率有密切的相关关系,是独立于年龄、体重指数和高血压家族史的高血压患病危险因素。
Objective To investigate the prevalence and influencing factors of hypertension in people with sleep apnea in our country. METHODS: Totally 2297 patients were enrolled in the Respiratory Medicine Clinic of 20 top three hospitals in China from 2004 to 2006, including 1310: 211 males and 13 females, all undergoing medical history, physical examination and polysomnography. Unified use of the Chinese Medical Association of respiratory disease branch of sleep respiratory disease group prepared “sleep apnea and hypertension incidence questionnaire” subjects questionnaire and normative blood pressure measurement. SPSS 11.0 software package was used for data analysis, using X ~ 2 test to compare the prevalence of hypertension. Results The prevalence of hypertension (23.5%) in patients with apnea-hypopnea index (AHI) <5 times / h (213 cases) was significantly lower than that in patients with AHI≥5 times / h 49.3%). The prevalence of hypertension in obstructive sleep apnea-hypopnea syndrome (OSAHS) population was 56.2% (569/1012). The prevalence of hypertension in family history of hypertension was 63.7% (450 / 706), which was significantly higher than that of 39.4% (627/1591) without family history. The prevalence of hypertension in AHI≥5 times / h group was 3 times higher than that in AHI <5 times / h group (OR = 3.167 , 95% CI 2.953 ~ 5.426, P <0.01). The prevalence of hypertension in the study population increased with the increase of AHI. The prevalence of hypertension increased significantly from 16 to 20 times / 70 times / h after a downward trend. The calculated formula: the prevalence of hypertension = 0.3199 + 0.0042 × AHI; hypertension OR = 1.018 +0.017 × AHI, at the same time, the prevalence of hypertension in subjects with sleep minimum oxygen saturation Decreased significantly higher, with the increase of sleepiness index increased significantly. The AHI for the subjects was a risk factor for hypertension independent of age, sex, body mass index, and family history of hypertension. Conclusions The prevalence of hypertension in patients with sleep apnea is significantly higher than that in patients without sleep apnea. Sleep apnea is closely related to the prevalence of hypertension and is independent of age, body mass index and family history of hypertension Risk factors.