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Upper airway surgery for obstructive sleep apnea reduces blood pressure.
Laryngoscope. 2017 Aug 10;:
Authors: Pang KP, Pang EB, Pang KA, Vicini C, Chan YH, Rotenberg BW
Abstract
OBJECTIVES/HYPOTHESIS: To evaluate if upper airway surgery reduces blood pressure in patients with obstructive sleep apnea (OSA).
STUDY DESIGN: Prospective series.
METHODS: A prospective series of 112 consecutive OSA patients with hypertension (HTN). All patients were > 18 years old, respiratory disturbance index >5, all levels of apnea-hypopnea index (AHI), with a history of HTN treated with medication for at least 6 months. Surgical procedures included septoplasty, turbinate reduction, palate surgery, and tongue base reduction.
RESULTS: There were 92 men and 20 women, with a mean age of 48.6 years, mean body mass index (BMI) was 27.5 (range, 19.7-34.7). Mean follow-up was 16.1 months. The mean preoperative AHI was 32.6 (range, 1.2-104), with the mean lowest oxygen saturation (LSAT) of 79.9% (range, 52%-93%). The mean adjusted preoperative and postoperative systolic blood pressure (SBP) was reduced from 146 ± 15.3 mm Hg to 122 ± 12.5 mm Hg (P < .001), and diastolic blood pressure (DBP) was reduced from 91 ± 10.2 mm Hg to 76 ± 7.8 mm Hg (P < .001). There was a decrease in overall BMI from 27.5 ± 3.6 to 25.5 ± 3.0 (P < .001); however, based on multivariate analysis, the reduction in SBP and DBP was not affected by this BMI reduction. Fifty-eight patients (51.8%) did not require their antihypertensive after surgery. There was poor correlation noted between HTN with AHI, LSAT, and oxygen duration <90%.
CONCLUSIONS: Upper airway surgery does reduce SBP and DBP in patients with OSA.
LEVEL OF EVIDENCE: 4. Laryngoscope, 2017.
PMID: 28795409 [PubMed - as supplied by publisher]
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