睡眠呼吸暂停相关心动减缓与晨起血压的关联性研究(英文）.pptVIP

Sleep Apnea associated- Bradycardia and the Morning Blood Pressure Background Apnea associated-Bradycardia  Corresponding BP Fluctuations Objective To explore the relevance of SA associated-bradycardia to the morning blood pressure To investigate the role of vagal nervous system plays in OSAHS associated hypertension Subjects N＝104 OSAHS patient M:F ＝ 94:10 Symptoms PE： BP Lab test polysomnography, PSG Methods PSGrespiratory inductive plethysmography，RIP Parameters involved Age Body Mass Index, BMI Apnea-Hypopnea Index, AHI Nocturnal Minimum of Arterial Oxygen Saturation, nSaO2％min Percentage of Dwell Time of Arterial Oxygen Saturation lower than 90%，DT90% Deviation of Heart Rate, DHR Blood Pressure MAP=DBP+1/3(SBP-DBP) Results The morning BP vs. Pre-sleep BP Comparison betweenthe morning BP and the Pre-sleep BP Construction of hypertension Relevance of DHR to the morning BP Relevance of DHR to the morning DBP Relevance of DHR to the morning HT Summary The morning DBP is elevated remarkably in OSAHS patients compared with the SBP SA associated-bradycardia is correlated with the morning diastolic blood pressure The amplitude of bradycardia during apnea (DHR) is an independent predictive factor of systolic HT next morning HYPOTHESIS THANK YOU! * Wuhan Union Hospital Xu Qing Respiratory Dept. obstructive sleep apnea-hypopnea syndrome OSAHS Apnea Intermittent Hypoxemia Arousal Systemic Hypertention OSAHS Apnea associated-Bradycardia Time(s) Heart rate(bpm) A pre-event period B hypopnea C post-event recovery period HR Barbara J. Morgan, SLEEP, 1998, 21:737-746. ？ HT △HR Vagal nerve Sympathetic nerve ？ BP elevated ？ △BP D area Respitrace, Ambulatory Monitoring, SensorMedics co. America * P 0.01，? Wilcoxon Rank sum test，? Paired t –test 0.000* - 7.894 6.01 ±7.76 (5.33) 101.83 ±12.32 (100) 95.82 ±11.50 (93.33) MAP (mm Hg) ? 0.000* - 6.918 6.62 ±7.37 (8) 88.58 ±10.64 (88) 81.96 ± 9.61 (80) DBP (mm Hg) ? 0.000* - 4.172 4