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Upper airway surgery for obstructive sleep apnea reduces blood pressure
Author(s) -
Pang Kenny P.,
Pang Edward B.,
Pang Kathleen A.,
Vicini Claudio,
Chan Yiong Huak,
Rotenberg Brian W.
Publication year - 2018
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26759
Subject(s) - medicine , obstructive sleep apnea , blood pressure , body mass index , septoplasty , anesthesia , respiratory disturbance index , prospective cohort study , airway , oxygen saturation , apnea , diastole , sleep apnea , surgery , polysomnography , nose , oxygen , chemistry , organic chemistry
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 , 128:523–527, 2018