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Yıl:2022; Cilt: 9; Sayı: 3>> Özet
TAM METİN
Türk Uyku Tıbbı Dergisi; 2022;9(3):238-243
Bursa Uludağ Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı, Bursa,
Y Dinç, A Bican Demir
Bursa Uludağ Üniversitesi, Bursa,
Amaç: Obstrüktif uyku apne sendromu (OUAS), uyku sırasında üst solunum yollarının kollapsından kaynaklanan ve geçici hipoksiye yol açan yaygın bir hastalıktır. OUAS ve hipertansiyon sıklıkla birlikte görülen ve multifaktöriyel hastalıklardır. Bu çalışmanın amacı, kendi popülasyonumuzda OUAS’li hastalarda hipertansiyon ve kardiyovasküler hastalıklar arasındaki ilişkiyi belirlemektir. Gereç ve Yöntem: Bu çalışmaya, 2016-2021 tarihleri arasında Bursa Uludağ Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı Uyku Laboratuvarı’nda OUAS tanısı alan 364 hasta dahil edilerek dosyaları retrospektif olarak tarandı. Hastalar hipertansiyonu olanlar ve olmayanlar olarak kıyaslanarak analiz edildi. Bulgular: Hipertansiyonu olan ve olmayan hastalar klinik, demografik ve polisomnografi verilerine göre kıyaslandığında, yaş (p<0,001), cinsiyet (p=0,009), diabetes mellitus (DM) varlığı (p<0,001), koroner arter hastalığı varlığı (p<0,001), kalp yetmezliği varlığı (p=0,020), atriyal fibrilasyon varlığı (p=0,004), iskemik inme öyküsü (p<0,001), tam kan değeri (p<0,001), serum kreatinin değeri (p=0,003), serum glukoz değeri (p=0,003), minumum oksijen satürasyonu (p=0,015), oksijen desatürasyon indeksi (p=0,034) ve vücut kitle indeksi (VKİ) (p<0,001) ile anlamlı istatistiksel ilişki saptandı. Anlamlı değişkenler binary logistik regresyon ile analiz edildiğinde en anlamlı değişkenlerin yaş [p<0,001, olasılık oranı (OO): 1,07), DM (p<0,001, OO: 7,58], koroner arter hastalığı varlığı (p=0,003, OO: 4,92), kalp yetmezliği (p=0,041, OO: 5,53), iskemik inme öyküsü (p=0,042, OO: 3,38) ve VKİ (p<0,001, OO: 1,28) olduğu saptandı. Sonuç: Bu çalışmada hipertansiyonu olan OUAS hastalarında koroner arter hastalığı, kalp yetmezliği ve iskemik inme gibi kardiyovasküler hastalıkların daha sık görüldüğünü ve bunun da yaş, DM ve VKİ gibi risk faktörlerinden bağımsız olduğu tespit edilmiştir. OUAS ve kardiyovasküler hastalıklar etnik ve ırksal farklılıklar gösterebilir. Bu sebeple, kendi popülasyonumuzda tansiyon regülasyonu ve kardiyovasküler hastalıklar üzerindeki etkisini inceleyen çok merkezli prospektif çalışmalar yapılmasını önermekteyiz.
Obstructive Sleep Apnea Syndrome and Cardiovascular Diseases; the Role of Hypertension
Objective: Obstructive sleep apnea syndrome (OSAS) is a common disorder that results from the collapse of the upper airways during sleep and causes temporary hypoxia. OSAS and hypertension are common and multifactorial diseases. aim This study aimed to determine the clinical, demographic, polysomnographic and prognostic features of OSAS patients with hypertension. Materials and Methods: In this study, 364 patients diagnosed with OSAS in the sleep laboratory of the Department of Neurology, Bursa Uludag University Faculty of Medicine between 2016 and 2021 were retrospectively scanned and included. The patients were analyzed by comparing them with and without hypertension. Results: When patients with and without hypertension were compared according to clinical, demographic and polysomnography data, age (p<0.001), sex (p=0.009), presence of diabetes mellitus (DM) (p<0.001), presence of coronary artery disease (p<0.001), presence of heart failure (p=0.020), presence of atrial fibrillation (p=0.004), ischemic stroke (p<0.001), minimum oxygen saturation (p=0.015), oxygen desaturation index (p=0.034) and body mass index (BMI) (p<0.001) were statistically significantly correlated. When the significant variables were analyzed with binary logistic regression, the most significant variables were age [p<0.001, odds ratio (OR): 1.07], DM (p<0.001, OR: 7.58), coronary artery disease (p=0.003, OR: 4.92), heart failure (p=0.041, OR: 5.53), ischemic stroke (p=0.042, OR: 3.38) and BMI (p<0.001, OR: 1.28). Conclusion: In this study, we found that cardiovascular diseases such as coronary artery disease, heart failure and ischemic stroke are more common in OSAS patients with hypertension, and this is independent of risk factors such as age, DM and BMI. OSAS and cardiovascular diseases may show ethnic and racial differences. For this reason, we suggest conducting multicenter prospective studies examining the effects on blood pressure regulation and cardiovascular diseases in our own population.

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