Obstractive sleep apnea syndrome and hypertension_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

WANG Hanqiao ¹ , HE Quanying ²

Corresponding author：

Keywords：

阻塞性睡眠呼吸暂停综合征; 高血压

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

阻塞性睡眠呼吸暂停综合征（OSAS）是在睡眠过程中上气道完全或部分狭窄导致患者反复呼吸暂停或低通气，出现鼾声、低氧血症及睡眠中反复微觉醒引起日间疲乏、嗜睡等症状的一组症候群。高血压是以体循环动脉压升高为主要特点的临床综合征，是最常见的心血管疾病，也是现代社会最主要的流行病之一。近十几年来，越来越多的研究证实OSAS与高血压的形成与发展独立相关，是非常重要的致高血压发生的危险因素[1-4]。
动脉压持续升高可导致心、脑、肾和血管等损害，并可引起全身代谢异常，严重危害人类的健康。但同时高血压又是可以防治的疾病，有效控制血压可明显地降低心脑血管疾病的死亡率。然而临床上难治性高血压的发生比例逐渐增加，原因之一在于部分由OSAS引起的继发性高血压被误诊为原发性高血压，从而使这些患者未得到根本性的病因治疗[5，6]。因此，如何预防和减少OSAS引起的高血压成为现代医学关注的焦点。本文将从流行病学、发病机制、临床意义及治疗几个方面论述OSAS与高血压之间的相关性。

Citation： WANG Hanqiao,HE Quanying. Obstractive sleep apnea syndrome and hypertension. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(4): 313-317. doi: Copy

1.	Nieto FJ，Young TB，Lind BK，et al.Association of sleep-disordered breathing，sleep apnea，and hypertension in a large community-based study.Sleep Heart Health Study.JAMA，2000，283：1829-1836.
2.	Young T，Peppard P，Palta M，et al.Population-based study of sleep-disordered breathing as a risk factor for hypertension.Arch Intern Med，1997，157：1746-1752.
3.	Peppard PE，Young T，Palta M，et al.Prospective study of the association between sleep-disordered breathing and hypertension.N Engl J Med，2000，342：1378-1384.
4.	Borgel J，Sanner BM，Keskin F，et al.Obstructive sleep apnea and blood pressure，interaction between the blood pressure-lowering effects of positive airway pressure therapy and antihypertensive drugs.Am J Hypertens，2004，17：1081-1087.
5.	Silverberg DS，Iaina A，Oksenberg A.Treating obstructive sleep apnea improves essential hypertension and quality of life.Am Fam Phys，2002，65：229-236.
6.	Chobanian AV，Bakris GL，Black HR，et al.The Seventh Report of the Joint National Committee on Prevention，Detection，Evaluation，and Treatment of High Blood Pressure：the JNC 7 Report.JAMA，2003，289：2560-2572.
7.	Drager LF，Pereira AC，Barreto-Filho JA.Phenotypic characteristics associated with hypertension in patients with obstructive sleep apnea.J Hum Hypertens，2006，20：523-528.
8.	Wang H，Zhang X，Yang Y，.et al.Relationship between sleep apnea hypopnea syndrome and cardiovascular events in elderly Chinese snorers.Chin Med J (Engl)，2002，115：1829-1832.
9.	中华医学会呼吸病学分会睡眠呼吸疾病学组.睡眠呼吸暂停人群高血压患病率的多中心研究.中华结核和呼吸杂志，2007，30：894-897.
10.	Schulz R，Grebe M，Eisele HJ，et al.Obstructive sleep apnea-related cardiovascular disease.Med Klin(Munich)，2006，101：321-327.
11.	Hedner J，Bengtsson-Bostrom K，Peker Y，et al.Hypertension prevalence in obstructive sleep apnoea and sex：a population-based case-control study.Eur Respir J，2006，27：564-570.
12.	Brooks D，Horner RL，Kozar LF，et al.Obstructive sleep apnea as a cause of systemic hypertension.Evidence from a canine model.J Clin Invest，1997，99：106-109.
13.	Bao G，Metreveli N，Fletcher EC.Acute and chronic blood pressure response to recurrent acoustic arousal in rats.Am J Hypertens，1999，12：504-510.
14.	Somers VK，Dyken ME，Clary MP，et al.Sympathetic neural mechanisms in obstructive sleep apnea.J Clin Invest，1995，96：1897-1904.
15.	Fletcher EC，Bao G.Effect of episodic eucapnic and hypocapnic hypoxia on systemic blood pressure in hypertension-prone rats.J Appl Physiol，1996，81：2088-2094.
16.	Bao G，Metreveli N，Li R，et al.Blood pressure response to chronic episodic hypoxia：role of the sympathetic nervous system.J Appl Physiol，1997，83：95-101.
17.	Cuspidi C，Macca G，Sampieri L，et al.Target organ damage and non-dipping pattern defined by two sessions of ambulatory blood pressure monitoring in recently diagnosed essential hypertensive patients.J Hypertens，2001，19：1539-1545.
18.	Kario K，Pickering TG，Umeda Y，et al.Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives：a prospective study.Circulation，2003，107：1401-1406.
19.	Cuspidi C，Meani S，Salerno M，et al.Cardiovascular target organ damage in essential hypertensives with or without reproducible nocturnal fall in blood pressure.J Hypertens，2004，22：273-280.
20.	Peter JH，Grote L，Fus E，et al.REM-sleep-hypertension in obstructive sleep apnea.Eur J Med Res，1995，18：132-136.
21.	Loredo JS，Ancoli-Israel S，Dimsdale JE.Sleep quality and blood pressure dipping in obstryctive sleep apnea.Am J Hypertens，2001，14：887-892.
22.	Akashiba T，Minemura H，Yamamoto H，et al.Nasal continuous positive airway pressure changes blood pressure "non-dippers" to "dippers" in patients with obstructive sleep apnea.Sleep，1999，22：849-853.
23.	Noda A，Yasuma F，Okada T，et al.Influence of movement arousal on circadian rhythm of blood pressure in obstructive sleep apnea syndrome.J Hypertens，2000，18：539-544.
24.	周燕斌，谢灿茂，严英硕，等.阻塞性睡眠呼吸暂停对动态血压影响的研究.中国实用内科杂志，2003，6：343-345.
25.	Suzuki M，Guilleminault C，Otsuka K，et al.Blood pressure "dipping" and "non-dipping" in obstructive sleep apnea syndrome patients.Sleep，1996，19：382-387.
26.	Nabe B，Lies A，Pankow W，et al.Determinants of circadian blood pressure rhythm and blood pressure variability in obstructive sleep apnoea.J Sleep Res，1995，4(S1)：97-101.
27.	Loredo JS，Nelesen R，Ancoli-Israel S，et al.Sleep quality and blood pressure dipping in normal adults.Sleep，2004，27：1097-1103.
28.	Silva AP，Moreira C，Bicho M，et al.Nocturnal sleep quality and circadian blood pressure variation.Rev Port Cardiol，2000，19：991-1005.
29.	Portaluppi F，Provini F，Cortelli P，et al.Undiagnosed sleep-disordered breathing among male nondippers with essential hypertension.J Hypertens，1997，15：1227-1233.
30.	邱原刚，姚雪艳，陶谦民，等.高血压患者治疗后血压昼夜节律及影响因素的调查.中华流行病学杂志2004，25：710-714.
31.	Logan AG，Perlikowski SM，Mente A，et al.High prevalence of unrecognized sleep apnoea in drug-resistant hypertension.J Hypertens，2001，19：2271-2277.
32.	Hla KM，Skatrud JB，Finn L，et al.The effect of correction of sleep-disordered breathing on BP in untreated hypertension.Chest，2002，122：1125-1132.
33.	Wilcox I，Grunstein RR，Hedner JA，et al.Effect of nasal continuous positive airway pressure during sleep on 24-hour blood pressure in obstructive sleep apnea.Sleep，1993，16：539-544.
34.	Sanner BM，Tepel M，Markmann A，et al.Effect of continuous positive airway pressure therapy on 24-hour blood pressure in patients with obstructive sleep apnea syndrome.Am J Hypertens，2002，15：251-257.
35.	夏书月，吴艺红，胡荣芳，等.持续正压通气治疗阻塞性睡眠呼吸暂停综合征合并高血压患者的动态血压变化.中国呼吸与危重监护杂志，2003，2：174-176.
36.	Pepperell JC，Ramdassingh-Dow S，Crosthwaite N，et al.Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea：a randomised parallel trial.Lancet，2002，359：204-210.
37.	Kaneko Y，Floras JS，Usui K，et al.Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea.N Engl J Med，2003，348：1233-1241.
38.	Usui K，Bradley TD，Spaak J，et al.Inhibition of awake sympathetic nerve activity of heart failure patients with obstructive sleep apnea by nocturnal continuous positive airway pressure.J Am Coll Cardiol，2005，21，45：2008-2011.
39.	Dimsdale JE，Loredo JS，Profant J，et al.Effect of continuous positive airway pressure on blood pressure：a placebo trial.Hypertension，2000，35：144-147.
40.	Logan AG，Tkacova R，Perlikowski SM，et al.Refractory hypertension and sleep apnoea：effect of CPAP on blood pressure and baroreflex.Eur Respir J，2003，21：241-247.
41.	Tun Y，Hida W，Okabe S，et al.Can nasal continuous positive airway pressure decrease clinic blood pressure in patients with obstructive sleep apnea? Tohoku J Exp Med，2003，201：181-190.
42.	Becker HF，Jerrentrup A，Ploch T，et al.Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea.Circulation，2003，107：68-78.
43.	Pankow W，Nabe B，Lies A，et al.Influence of obstructive sleep apnoea on circadian blood pressure profile.J Sleep Res，1995，4(S1)：102-106.
44.	Gotsopoulos H，Kelly JJ，Cistulli PA.Oral appliance therapy reduces blood pressure in obstructive sleep apnea：a randomized，controlled trial.Sleep，2004，27：934-941.

1. Nieto FJ，Young TB，Lind BK，et al.Association of sleep-disordered breathing，sleep apnea，and hypertension in a large community-based study.Sleep Heart Health Study.JAMA，2000，283：1829-1836.
2. Young T，Peppard P，Palta M，et al.Population-based study of sleep-disordered breathing as a risk factor for hypertension.Arch Intern Med，1997，157：1746-1752.
3. Peppard PE，Young T，Palta M，et al.Prospective study of the association between sleep-disordered breathing and hypertension.N Engl J Med，2000，342：1378-1384.
4. Borgel J，Sanner BM，Keskin F，et al.Obstructive sleep apnea and blood pressure，interaction between the blood pressure-lowering effects of positive airway pressure therapy and antihypertensive drugs.Am J Hypertens，2004，17：1081-1087.
5. Silverberg DS，Iaina A，Oksenberg A.Treating obstructive sleep apnea improves essential hypertension and quality of life.Am Fam Phys，2002，65：229-236.
6. Chobanian AV，Bakris GL，Black HR，et al.The Seventh Report of the Joint National Committee on Prevention，Detection，Evaluation，and Treatment of High Blood Pressure：the JNC 7 Report.JAMA，2003，289：2560-2572.
7. Drager LF，Pereira AC，Barreto-Filho JA.Phenotypic characteristics associated with hypertension in patients with obstructive sleep apnea.J Hum Hypertens，2006，20：523-528.
8. Wang H，Zhang X，Yang Y，.et al.Relationship between sleep apnea hypopnea syndrome and cardiovascular events in elderly Chinese snorers.Chin Med J (Engl)，2002，115：1829-1832.
9. 中华医学会呼吸病学分会睡眠呼吸疾病学组.睡眠呼吸暂停人群高血压患病率的多中心研究.中华结核和呼吸杂志，2007，30：894-897.
10. Schulz R，Grebe M，Eisele HJ，et al.Obstructive sleep apnea-related cardiovascular disease.Med Klin(Munich)，2006，101：321-327.
11. Hedner J，Bengtsson-Bostrom K，Peker Y，et al.Hypertension prevalence in obstructive sleep apnoea and sex：a population-based case-control study.Eur Respir J，2006，27：564-570.
12. Brooks D，Horner RL，Kozar LF，et al.Obstructive sleep apnea as a cause of systemic hypertension.Evidence from a canine model.J Clin Invest，1997，99：106-109.
13. Bao G，Metreveli N，Fletcher EC.Acute and chronic blood pressure response to recurrent acoustic arousal in rats.Am J Hypertens，1999，12：504-510.
14. Somers VK，Dyken ME，Clary MP，et al.Sympathetic neural mechanisms in obstructive sleep apnea.J Clin Invest，1995，96：1897-1904.
15. Fletcher EC，Bao G.Effect of episodic eucapnic and hypocapnic hypoxia on systemic blood pressure in hypertension-prone rats.J Appl Physiol，1996，81：2088-2094.
16. Bao G，Metreveli N，Li R，et al.Blood pressure response to chronic episodic hypoxia：role of the sympathetic nervous system.J Appl Physiol，1997，83：95-101.
17. Cuspidi C，Macca G，Sampieri L，et al.Target organ damage and non-dipping pattern defined by two sessions of ambulatory blood pressure monitoring in recently diagnosed essential hypertensive patients.J Hypertens，2001，19：1539-1545.
18. Kario K，Pickering TG，Umeda Y，et al.Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives：a prospective study.Circulation，2003，107：1401-1406.
19. Cuspidi C，Meani S，Salerno M，et al.Cardiovascular target organ damage in essential hypertensives with or without reproducible nocturnal fall in blood pressure.J Hypertens，2004，22：273-280.
20. Peter JH，Grote L，Fus E，et al.REM-sleep-hypertension in obstructive sleep apnea.Eur J Med Res，1995，18：132-136.
21. Loredo JS，Ancoli-Israel S，Dimsdale JE.Sleep quality and blood pressure dipping in obstryctive sleep apnea.Am J Hypertens，2001，14：887-892.
22. Akashiba T，Minemura H，Yamamoto H，et al.Nasal continuous positive airway pressure changes blood pressure "non-dippers" to "dippers" in patients with obstructive sleep apnea.Sleep，1999，22：849-853.
23. Noda A，Yasuma F，Okada T，et al.Influence of movement arousal on circadian rhythm of blood pressure in obstructive sleep apnea syndrome.J Hypertens，2000，18：539-544.
24. 周燕斌，谢灿茂，严英硕，等.阻塞性睡眠呼吸暂停对动态血压影响的研究.中国实用内科杂志，2003，6：343-345.
25. Suzuki M，Guilleminault C，Otsuka K，et al.Blood pressure "dipping" and "non-dipping" in obstructive sleep apnea syndrome patients.Sleep，1996，19：382-387.
26. Nabe B，Lies A，Pankow W，et al.Determinants of circadian blood pressure rhythm and blood pressure variability in obstructive sleep apnoea.J Sleep Res，1995，4(S1)：97-101.
27. Loredo JS，Nelesen R，Ancoli-Israel S，et al.Sleep quality and blood pressure dipping in normal adults.Sleep，2004，27：1097-1103.
28. Silva AP，Moreira C，Bicho M，et al.Nocturnal sleep quality and circadian blood pressure variation.Rev Port Cardiol，2000，19：991-1005.
29. Portaluppi F，Provini F，Cortelli P，et al.Undiagnosed sleep-disordered breathing among male nondippers with essential hypertension.J Hypertens，1997，15：1227-1233.
30. 邱原刚，姚雪艳，陶谦民，等.高血压患者治疗后血压昼夜节律及影响因素的调查.中华流行病学杂志2004，25：710-714.
31. Logan AG，Perlikowski SM，Mente A，et al.High prevalence of unrecognized sleep apnoea in drug-resistant hypertension.J Hypertens，2001，19：2271-2277.
32. Hla KM，Skatrud JB，Finn L，et al.The effect of correction of sleep-disordered breathing on BP in untreated hypertension.Chest，2002，122：1125-1132.
33. Wilcox I，Grunstein RR，Hedner JA，et al.Effect of nasal continuous positive airway pressure during sleep on 24-hour blood pressure in obstructive sleep apnea.Sleep，1993，16：539-544.
34. Sanner BM，Tepel M，Markmann A，et al.Effect of continuous positive airway pressure therapy on 24-hour blood pressure in patients with obstructive sleep apnea syndrome.Am J Hypertens，2002，15：251-257.
35. 夏书月，吴艺红，胡荣芳，等.持续正压通气治疗阻塞性睡眠呼吸暂停综合征合并高血压患者的动态血压变化.中国呼吸与危重监护杂志，2003，2：174-176.
36. Pepperell JC，Ramdassingh-Dow S，Crosthwaite N，et al.Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea：a randomised parallel trial.Lancet，2002，359：204-210.
37. Kaneko Y，Floras JS，Usui K，et al.Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea.N Engl J Med，2003，348：1233-1241.
38. Usui K，Bradley TD，Spaak J，et al.Inhibition of awake sympathetic nerve activity of heart failure patients with obstructive sleep apnea by nocturnal continuous positive airway pressure.J Am Coll Cardiol，2005，21，45：2008-2011.
39. Dimsdale JE，Loredo JS，Profant J，et al.Effect of continuous positive airway pressure on blood pressure：a placebo trial.Hypertension，2000，35：144-147.
40. Logan AG，Tkacova R，Perlikowski SM，et al.Refractory hypertension and sleep apnoea：effect of CPAP on blood pressure and baroreflex.Eur Respir J，2003，21：241-247.
41. Tun Y，Hida W，Okabe S，et al.Can nasal continuous positive airway pressure decrease clinic blood pressure in patients with obstructive sleep apnea? Tohoku J Exp Med，2003，201：181-190.
42. Becker HF，Jerrentrup A，Ploch T，et al.Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea.Circulation，2003，107：68-78.
43. Pankow W，Nabe B，Lies A，et al.Influence of obstructive sleep apnoea on circadian blood pressure profile.J Sleep Res，1995，4(S1)：102-106.
44. Gotsopoulos H，Kelly JJ，Cistulli PA.Oral appliance therapy reduces blood pressure in obstructive sleep apnea：a randomized，controlled trial.Sleep，2004，27：934-941.

Previous Article
验证治疗措施的公平——高质量研究促进高质量卫生保健（Ⅵ）

Chinese Journal of Respiratory and Critical Care Medicine

Obstractive sleep apnea syndrome and hypertension

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Format

Content