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1、Sleep Apnea associated- Bradycardia and the Morning Blood Pressure,Background,obstructive sleep apnea-hypopnea syndrome OSAHS,Apnea Intermittent Hypoxemia Arousal,Systemic Hypertention,Apnea associated-Bradycardia & Corresponding BP Fluctuations,OSAHS Apnea associated-Bradycardia,Time(s),Heart rate(
2、bpm),Barbara J. Morgan, SLEEP, 1998, 21:737-746.,？,HT,HR,Vagal nerve,Sympathetic nerve,？,BP elevated,？,BP,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,N104
3、 OSAHS patient M:F 94:10 Symptoms PE： BP Lab test polysomnography, PSG,Methods,PSG respiratory inductive plethysmography，RIP,Respitrace, Ambulatory Monitoring, SensorMedics co. America,Parameters involved,Age Body Mass Index, BMI Apnea-Hypopnea Index, AHI Nocturnal Minimum of Arterial Oxygen Saturat
4、ion, nSaO2min 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 between the morning BP and the Pre-sleep BP,Construction of hypertension,Relevance of DHR to t
5、he morning BP,Relevance of DHR to the morning DBP,DBP: diastolic blood pressure,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,？,HT,HR,Vagal nerve,Sympathetic nerve,？,Elevated BP,？,BP,THANK YOU!,