Children with obstructive sleep apnea (OSA) and hypertension experienced significant improvements in blood pressure after adenotonsillectomy, according the results of a retrospective case series study published in JAMA Otolaryngology—Head & Neck Surgery, reports Pulmonology Advisor.
Cho-Hsueh Lee, MD, from the Department of Otolaryngology, National Taiwan University, College of Medicine and National Taiwan University Hospital in Taipei, and colleagues analyzed preoperative and postoperative polysomnographic data of children (age, <18 years) with symptoms of OSA (apnea-hypopnea index, >1) treated at National Taiwan University Hospital between January 1, 2010, and April 30, 2016. All children with OSA underwent adenotonsillectomy. Blood pressure (BP) was measured in a sleep center before (nocturnal BP) and after (morning BP) polysomnography.
A total of 240 nonobese children with OSA and a mean age of 7.3 years were recruited (66.7% boys).The apnea-hypopnea index decreased significantly from 12.1 to 1.7 events per hour after adenotonsillectomy (95% CI of difference, ?12.3 to ?8.4 events per hour). All patients experienced a significant decrease in nocturnal diastolic BP (from 66.9 to 64.5 mm Hg; 95% CI of difference, ?4.1 to ?0.7 mm Hg) and morning diastolic BP (from 66.9 to 64.4 mm Hg; 95% CI of difference, ?4.2 to ?0.8 mm Hg). The percentage of patients with diastolic BP in the >95th percentile decreased significantly from 20.0% to 13.8% (nocturnal BP; 95% CI of difference, ?12.1% to ?0.4%) and from 21.7% to 14.2% (morning BP; 95% CI of difference, ?13.6% to ?1.4%).