1-6OBSTRUCTIVE SLEEP APNEA IN RESISTANT HYPERTENSION

Abstract

Background: HTN is considered resistant when the blood pressure (BP) remains above goal (≥140/90 mmHg) despite lifestyle modification and administration of three antihypertensive agents of different classes, including a diuretic. Obstructive sleep apnea (OSA) is associated with hypoxia, hypercapnia, arousal, and fluctuations of intrathoracic pressure which all contribute to the sympathetic overdrive. The association of resistant hypertension and obstructive sleep apnea are documented in several previous studies. The data from Indonesia are very limited. Aim: Measure the association between obstructive sleep apnea and resistant hypertension. Method: This is a cross-sectional study. The presence of sleep apnea is measured with complete polysomnography (PSG). Resistant hypertension is generally defined as uncontrolled clinic blood pressure (>140/90 mm Hg) after treatment with three or more antihypertensives. The data about medication were obtained from computerized electronic prescription. The data of adherence are measured with the Morisky Adherence scale. We measure the apnea and hypopnea events per hour, which is called the apnea-hypopnea index (AHI), is used to grade OSA. The data presented in a systematic table. Result: The data were obtained from 12 patients with resistant hypertension. The data consist of 8 male and four female. Complete PSG was recorded in all subjects. The result showed that ten patients have obstructive sleep apnea. Severe obstructive sleep apnea (AHI> 30) presence in 7 patients. The data of CPAP/ APAP usage are obtained from 4 subjects. The result showed that blood pressure control is much better after the use of CPAP/ APAP. Conclusion: OSA is very prevalent in resistant hypertension. OSA should be evaluated in patients with resistant hypertension.