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Hypertension:原发性醛固酮增多症和阻塞性睡眠呼吸暂停

2019-11-04 xing.T MedSci原创

总之,醛固酮水平升高可能会导致白人醛固酮过多症患者的OSA严重程度增加,但OSA患者的PA风险并未升高。本研究的结果对内分泌学会指南的当前建议提出了挑战,即所有OSA患者均应筛查PA,无论其高血压程度如何。

原发性醛固酮增多症(PA)与阻塞性睡眠呼吸暂停(OSA)之间的关联一直是争论的主题。2016年内分泌学会指南建议对所有患有OSA的高血压患者进行PA筛查。近日,心血管权威杂志Hypertension上发表了一篇研究文章,研究人员设计了一项多中心、多种族横断面研究,以评估OSA患者中PA的患病率以及未经选择的PA患者OSA的患病率。

研究人员通过心肺描记法对203名OSA患者(102名白人和101名中国人)进行了PA筛查,对207名PA患者(104名白人,100名中国人和3名非洲人后裔)进行了OSA筛查。

18例OSA患者(8.9%)患有PA(白人占11.8%,华裔占5.9%)。在没有其他PA检查适应症的患者中,PA患病率降至1.5%。PA患者的OSA患病率为67.6%,在白人和中国患者中均一致。在患有PA的白人患者中,醛固酮水平与呼吸暂停/呼吸不足指数之间存在相关性(R2=0.225,P=0.016),而在中国患者中则不存在这种相关性。多因素Logistic回归分析证实了白人患者血浆醛固酮水平与中度至重度OSA诊断之间存在显著且独立的关联(比值比为1.002;P=0.002)。

总之,醛固酮水平升高可能会导致白人醛固酮过多症患者的OSA严重程度增加,但OSA患者的PA风险并未升高。本研究的结果对内分泌学会指南的当前建议提出了挑战,即所有OSA患者均应筛查PA,无论其高血压程度如何。

原始出处:

Fabrizio Buffolo.et al.Primary Aldosteronism and Obstructive Sleep Apnea A Cross-Sectional Multi-Ethnic Study.Hypertension.2019.https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.119.13833

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ipAttribution=)]
    2019-11-15 feather89
  5. 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target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9238, encryptionId=f2db9238f9, topicName=Hypertension)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11ff9497046, createdName=jambiya, createdTime=Wed Nov 06 13:51:00 CST 2019, time=2019-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596582, encodeId=4ecc15965825f, content=<a href='/topic/show?id=70e4396491a' target=_blank style='color:#2F92EE;'>#呼吸暂停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39649, encryptionId=70e4396491a, topicName=呼吸暂停)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2a518392360, createdName=119337463, createdTime=Wed Nov 06 13:51:00 CST 2019, time=2019-11-06, status=1, ipAttribution=)]
    2020-02-17 tomyang96
  6. 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  7. 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target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9238, encryptionId=f2db9238f9, topicName=Hypertension)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11ff9497046, createdName=jambiya, createdTime=Wed Nov 06 13:51:00 CST 2019, time=2019-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596582, encodeId=4ecc15965825f, content=<a href='/topic/show?id=70e4396491a' target=_blank style='color:#2F92EE;'>#呼吸暂停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39649, encryptionId=70e4396491a, topicName=呼吸暂停)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2a518392360, createdName=119337463, createdTime=Wed Nov 06 13:51:00 CST 2019, time=2019-11-06, status=1, ipAttribution=)]
    2019-11-06 cmsvly
  8. 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