24-Hour Ambulatory Blood Pressure after Adenotonsillectomy in Childhood Sleep Apnea
Journal
Journal of Pediatrics
Journal Volume
199
Pages
112-117.e6
Date Issued
2018
Author(s)
Abstract
Objective: To assess the effects of adenotonsillectomy (T&A) on ambulatory blood pressure (ABP) in childhood obstructive sleep apnea (OSA). Study design: 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. Results: 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). Conclusions: Overall, in children with OSA, the 24-hour ABP change after T&A is small. However, among children with preoperative hypertension, there is significant BP improvement after T&A surgery. ? 2018 Elsevier Inc.
SDGs
Other Subjects
adenotonsillectomy; adolescent; apnea hypopnea index; Article; blood pressure monitoring; cardiovascular risk; child; cohort analysis; controlled study; correlation coefficient; day length; diastolic blood pressure; diastolic hypertension; disease association; female; human; hypertension; independent variable; major clinical study; male; night; pediatric cardiology; polysomnography; postoperative period; preoperative evaluation; prevalence; priority journal; sleep disordered breathing; systolic blood pressure; systolic hypertension; adenoidectomy; blood pressure; blood pressure monitoring; follow up; pathophysiology; physiology; preschool child; procedures; retrospective study; risk factor; severity of illness index; sleep disordered breathing; tonsillectomy; Adenoidectomy; Adolescent; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Male; Polysomnography; Retrospective Studies; Risk Factors; Severity of Illness Index; Sleep Apnea Syndromes; Tonsillectomy
Publisher
Mosby Inc.
Type
journal article