24-Hour Ambulatory Blood Pressure after Adenotonsillectomy in Childhood Sleep Apnea

The Journal of Pediatrics
Wei-Chung HsuChe-Yi Lin

Abstract

To assess the effects of adenotonsillectomy (T&A) on ambulatory blood pressure (ABP) in childhood obstructive sleep apnea (OSA). From 2012 to 2017, children aged 4-16 years with symptoms and polysomnography-diagnosed OSA (apnea-hypopnea index [AHI] >1) underwent T&A. PSG studies and 24-hour ABP monitoring were performed before and at 3 months after surgery. In total, 159 children were enrolled (mean age, 7.8 ± 3.3 years; 72% male). T&A significantly reduced the AHI from 12.4 ± 15.9 events/hour to 2.7 ± 5.7 events/hour (P < .001). A decrease was observed in the children's overall diastolic blood pressure (65.1 ± 6.1 mm Hg to 63.8 ± 7.4 mm Hg, P = .04) after surgery. In subgroup analysis, 100 (63%) patients were classified as nonhypertensive, and 59 (37%) were classified as hypertensive. Linear mixed model analysis revealed that compared with the children without hypertension, those with hypertension had superior improvement in systolic and diastolic blood pressure during daytime and nighttime (all P values < .01). The ABP changes after surgery were not correlated with the AHI changes. Finally, preoperative hypertension was an independent risk factor of postoperative hypertension among these children (OR 3.66; 95% CI 1.70-7.86). ...Continue Reading

Citations

Jan 23, 2019·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Kun-Tai KangWei-Chung Hsu
Dec 11, 2019·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Chia-Hsuan LeeKun-Tai Kang
Feb 19, 2020·Pediatric Pulmonology·Masrur A KhanJoseph Mahgerefteh
Jul 28, 2019·Current Hypertension Reports·Sonali S Patel, Stephen R Daniels
Aug 17, 2020·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Deniz AvcıAyşegül Hartoka Sevinç
Sep 8, 2020·Current Hypertension Reports·Lourdes M DelRossoRaffaele Ferri
Aug 19, 2021·Journal of the American Heart Association·Carissa M Baker-SmithUNKNOWN American Heart Association Athero, Hypertension and Obesity in the Young Committee of the Council on Lifelong Congenital Hea

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