Abstract
Background: We sought to investigate whether long-term continuous positive airway pressure (CPAP) treatment in patients with obstructive sleep apnea (OSA) and resistant hypertension (RHTN) could attenuate the cardiovascular disease risk by lowering their body-mass index (BMI). Methods: This was a long-term observational study of RHTN patients diagnosed with OSA. Patients were evaluated with polysomnography initially and after a mean follow-up period of four years. The patients were divided into two groups based on their compliance to CPAP therapy. Results: 33 patients (aged 54.67 ± 7.5, 18 men, 54.5%) were included in the study, of which 12 were compliant to CPAP therapy. A significant reduction in BMI at follow-up was noted in patients compliant to CPAP therapy (1.4 ± 3.5 vs. −1.6 ± 2.5, p = 0.006). We also noted a large effect size reduction in abdominal circumference at follow-up in the CPAP group. At follow-up evaluation, the mean heart rate (b/min) was lower in the CPAP group (58.6 ± 9.5 vs. 67.8 ± 7.8), while arrhythmia prevalence increased between initial (28.6%) and follow-up (42.9%) evaluation with an intermediate effect size in non-compliant patients. Conclusions: In our cohort of OSA patients with RHTN, long-term adherence to CPAP therapy was associated with weight loss and improvement in cardiac rhythm outcomes.
Highlights
Resistant hypertension (RHTN) is defined as blood pressure that remains above 140/90 mmHg despite the use of at least three antihypertensive medications of different classes at the best tolerated doses [1]
Background: We sought to investigate whether long-term continuous positive airway pressure (CPAP) treatment in patients with obstructive sleep apnea (OSA) and resistant hypertension (RHTN) could attenuate the cardiovascular disease risk by lowering their body-mass index (BMI)
The patient sample was divided into two groups based on their compliance with CPAP therapy: 12 patients (36.4%)—subsequently named “CPAP group”—followed the CPAP treatment from the diagnosis up until the follow-up visit, while the others were not compliant or did not use CPAP therapy at all—subsequently named “non-CPAP group” (Figure 1)
Summary
Resistant hypertension (RHTN) is defined as blood pressure that remains above 140/90 mmHg despite the use of at least three antihypertensive medications of different classes at the best tolerated doses [1]. Obstructive sleep apnea (OSA) is a common sleep disorder with a prevalence of up to 21% in the general population and a significant increase with age [3] It is defined by recurrent episodes of upper airway obstruction that determines sleep fragmentation, intermittent hypoxia and increased sympathetic activity, further triggering intermediate mechanisms, including elevated blood pressure with a non-dipper blood pressure pattern [4]. We sought to investigate whether long-term continuous positive airway pressure (CPAP) treatment in patients with obstructive sleep apnea (OSA) and resistant hypertension (RHTN) could attenuate the cardiovascular disease risk by lowering their body-mass index (BMI). At follow-up evaluation, the mean heart rate (b/min) was lower in the CPAP group (58.6 ± 9.5 vs 67.8 ± 7.8), while arrhythmia prevalence increased between initial (28.6%) and follow-up (42.9%) evaluation with an intermediate effect size in non-compliant patients. Conclusions: In our cohort of OSA patients with RHTN, long-term adherence to CPAP therapy was associated with weight loss and improvement in cardiac rhythm outcomes
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