PREVALENCE AND ASSOCIATED FACTORS OF OBSTRUCTIVE SLEEP APNEA IN REFRACTORY HYPERTENSION
OBJECTIVE:To investigate OSA prevalence and polysomnography (PSG) pattern in patients with refractory hypertension of a large cohort of resistant hypertension (RHT). DESIGN AND METHOD:This is a cross sectional study involving 418 RHT patients (30.9% male with average age of 62.5 ± 9.9 years) that we...
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| Published in: | Journal of hypertension Vol. 37 Suppl 1; p. e25 |
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| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Copyright Wolters Kluwer Health, Inc. All rights reserved
01-07-2019
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| Online Access: | Get full text |
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| Summary: | OBJECTIVE:To investigate OSA prevalence and polysomnography (PSG) pattern in patients with refractory hypertension of a large cohort of resistant hypertension (RHT).
DESIGN AND METHOD:This is a cross sectional study involving 418 RHT patients (30.9% male with average age of 62.5 ± 9.9 years) that were submitted to full-night PSG. OSA presence was defined by an apnea-hypopnea index (AHI) > 5 per hour and mild-severe OSA by AHI > = 15 per hour. Refractory hypertension was defined by uncontrolled ABPM using 5 or more anti-hypertensive drugs, including spironolactone. Statistical analysis included bivariate analysis comparing resistant and refractory hypertensive patients using Mann-Whitney and chi-square tests.
RESULTS:A total of 88 patients (21.1%) were diagnosed with refractory hypertension (25.0% male with mean age of 58.8 ± 8.0 years). In comparison with resistant ones, refractory hypertensives are younger, with higher smoking (18.2% vs 9.7%, p = 0.04) and previous CV diseases (50.0% vs 34.8%, p = 0.013) prevalence, especially cerebrovascular accident (21.6% vs 10.3%, p = 0.007). There was no difference in relation to anthropometric measures.OSA prevalence (80.7% vs 82.7%, p = 0.64) and mild/severe OSA (51.1% vs 57.0%, p = 0.34) were similar in both groups as well as AHI (15 [6–35] vs 17 [7–38], p = 0.46). In its turn, refractory hypertensives presented better sleep efficiency (78% vs 71%, p < 0.001), with higher total sleep time (315 min vs 281 min, p < 0.001) and lower sleep latency (11 min vs 17 min, p = 0.03). There was no difference in relation to REM sleep, oxygen saturation, micro-arousals index and periodic limb movement.
CONCLUSIONS:Resistant and refractory hypertensives have similar OSA prevalence although refractory ones appear to have a better sleep pattern, possibly because they are younger and due to spironolactone use. |
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| ISSN: | 0263-6352 1473-5598 |
| DOI: | 10.1097/01.hjh.0000570604.67049.44 |