原发性高血压患者收缩压负荷与睡眠稳定性的关系探讨

Relationship between systolic blood pressure load and sleep stability in patients with essential hypertension

目的运用24 h动态血压监测和心肺耦合测评分析技术(CPC)探讨高血压患者收缩压负荷与睡眠稳定性的关系。方法纳入2017年1月至2018年8月在中日友好医院国际部心功能检查室检测的原发性高血压患者155例,根据收缩压负荷是否>50%将受试者分为高负荷组和低负荷组,通过logistic回归分析收缩压负荷与睡眠稳定性的关系。结果多因素logistic回归分析显示,在调整性别、年龄、体重指数(BMI)后稳定睡眠是高血压患者夜间收缩压负荷降低的保护因素(OR=0.736,P=0.047);不稳定睡眠是日间收缩压负荷升高的危险因素(OR=1.336,P=0.037)。结论睡眠稳定性对收缩压负荷的影响存在昼夜差异性,稳定睡眠是夜间收缩压负荷降低的保护因素,不稳定睡眠是日间收缩压负荷升高的有害因素;增加睡眠稳定性有助于降低收缩压负荷。

Objective To explore the relationship between blood pressure load and sleep stability in hypertensive patients by cardiopulmonary coupling monitoring(CPC)and 24-hour ambulatory blood pressure monitoring.Methods One hundred and fifty-five patients with essential hypertension were divided into high load group and low load group according to whether the blood pressure load was higher than 50%.The relationship between sleep stability and systolic blood pressure load was analyzed by logistic regression.Results After adjusting for sex,age and body mass index(BMI),logistic regression analysis showed that stable sleep was the protective factor(OR=0.736,P=0.047)for the decrease of nocturnal blood pressure load,and unstable sleep was the risk factor for increasing day time blood pressure load(OR=1.336,P=0.037)in patients with hypertension.Conclusions The effect of sleep stability on blood pressure load is different between day and night.Stable sleep is the protective factor of nocturnal systolic blood pressure load decrease,and unstable sleep is the harmful factor of daytime systolic blood pressure load increase.Increasing sleep stability helps to reduce systolic blood pressure load.