Effect of uvulopalatopharyngoplasty on obstructive sleep apnea hypopnea syndrome in patients with resistant hypertension

Objective To investigate the effect of uvulopalatopharyngoplasty （UPPP） to obstructive sleep apnea hypopnea syndrome （OSAHS） in patients with resistant hypertension （RH）. Methods UPPP and modified UPPP were performed on 36 moderate and severe OSAHS patients, who also suffered from RH [ who taking more than three kinds of antihypertensive drugs （including diuretics ） and still not able to control blood pressure at 140/90 mm Hg （1 mm Hg = 0.133 kPa）]. Polysomnography monitoring, ambulatory blood pressure monitoring, apnea hypopnea index （AHI）, lowest saturation of blood oxygen （SaO2） and the changes of antihypertensive medication dosage were performed to the patients before and 6 months after the surgery. Results Six months after surgery,the total efficiency was 61.1% （22/36）. The AHI median [ 25 quantile; 75 quantile] from 37.5 [26.0; 48.3]/h to 9.5 [9.0; 21.3]/h, the lowest the SaO2 average （x±s, the same below） increased from 0.655 ±0.114 to 0.860 ±0.037, the differences were statistically significant （P value 0.80 and r2 > 0.50）. The average numbers of antihypertensive drugs decreased form （3.6±0.5） to （2.9± 0.5 ） compared preoperatively and postoperatively, the difference was statistically significant （t = 5.537, P < 0.01）. The use of antihypertensive medication reduced in 23 cases （23/36, 63.8%） compared preoperatively and postoperatively. Conclusions The blood pressure of the patients with OSAHS and RH dropped significantly after UPPP surgery. Recent follow-up shows that the varieties of antihypertensive drugs taken in these patients are reduced significantly after operation. Key words: Sleep apnea, obstructive; Hypertension; Otorhinolaryngologic surgical procedures