诊断学理论与实践2026，Vol.25Issue(4)：389-398,10.DOI:10.16150/j.1671-2870.2026.04.001
阻塞性睡眠呼吸暂停相关高血压研究进展
Research progress on obstructive sleep apnea-related hypertension
摘要
Abstract
Obstructive sleep apnea(OSA)-related hypertension is a complex clinical syndrome involving multisys-tem damage throughout the body.It is characterized by repeated upper airway obstruction during sleep,leading to apnea,hypopnea,and/or respiratory effort-related microarousals.These events result in chronic intermittent hypoxia,carbon diox-ide retention,sympathetic nervous system activation,sleep fragmentation,which in turn contribute to chronic hypoxia and elevated blood pressure.The typical manifestations are refractory hypertension,nocturnal hypertension,and elevated morn-ing blood pressure,presenting a non-dipper or reverse-dipper blood pressure rhythm.OSA-related hypertension can be classified into hypoxic burden type,high-arousal type,high-loop-gain type,upper airway collapse type,high-aldosterone type,mixed type,and other types.Currently,clinical management and treatment goal setting of OSA-related hypertension overly rely on the apnea-hypopnea index(AHI).In clinical practice,there are issues including insufficient consideration of patient heterogeneity and pathophysiological classification,inadequate consideration of comorbidities and confounding fac-tors,poor adherence to continuous positive airway pressure(CPAP),and insufficient effective therapeutic dosage,all of which pose new challenges to disease diagnosis,treatment,and patient management.In addition,OSA-related hypertension often coexists with obesity,tumors,primary aldosteronism,metabolic syndrome,insulin resistance,chronic kidney disease,and other conditions,particularly in elderly patients.Therefore,based on precise heterogeneity and pathophysiological clas-sification,a multidimensional assessment and treatment strategy for OSA-related hypertension centered on AHI and hypoxic burden—combined with lifestyle interventions,effective hypoxic burden reduction,weight loss and sleep manage-ment,pharmacotherapy,CPAP therapy,catheter-based renal denervation,surgical intervention,device therapy,technologi-cal innovations such as artificial intelligence,policy support,health insurance policies,and patient engagement—should be adopted to establish a new lifelong management and treatment system.关键词
阻塞性睡眠呼吸暂停/高血压/睡眠呼吸暂停低通气指数/持续气道正压通气/治疗Key words
Obstructive sleep apnea/Hypertension/Apnea-hypopnea index/Continuous positive airway pressure/Therapy分类
医药卫生引用本文复制引用
钟久昌,董昭杰..阻塞性睡眠呼吸暂停相关高血压研究进展[J].诊断学理论与实践,2026,25(4):389-398,10.基金项目
国家自然科学基金(82570477 （）
82370432) （）
国家科技重大专项课题(2024ZD0531200) （2024ZD0531200）
