OP-346 An Overlooked Cause of Resistant Hypertension; Upper Airway Resistance Syndrome

Abstract

ObjectiveUpper airway resistance syndrome is a sleep disordered breathing syndrome characterized by repetetive arousals resulting in sympathetic overactivity. We aimed to determine whether upper airway resistance syndrome is related to resistant hypertension.MethodsFourty patients with resistant hypertension were enrolled in the study. All patients underwent polysomnographic examination. All patients underwent 24 hours ambulatory blood pressure monitoring in order to rule out white coat syndrome and to monitor treatment efficiency.ResultsTwenty-two patients (55%) were diagnosed with obstructive sleep apnoea and 14 patients (35%) were diagnosed with upper airway resistance syndrome according to American Sleep Disorders Association criteria. Upper airway resistance syndrome patients were younger and had a lower BMI when compared to other patients while there were no difference between the blood pressure levels and the number of antihypertensive drugs. Arousal index was determined to be positively correlated with systolic blood pressure level (p=0.034; r=0.746 ) while epword score and apnea-hypopnea index were independent of disease severity (p=0.435, r=0.323 and p=0.819, r= -0.097 respectively). Eight patients were treated with positive airway pressure treatment and blood pressure control was achieved in all whereas no pressure reduction was observed in 4 untreated patients.ConclusionsWe concluded that upper airway resistance syndrome is a possible secondary cause of resistant hypertension and its proper treatment can result in dramatic blood pressure control. ObjectiveUpper airway resistance syndrome is a sleep disordered breathing syndrome characterized by repetetive arousals resulting in sympathetic overactivity. We aimed to determine whether upper airway resistance syndrome is related to resistant hypertension. Upper airway resistance syndrome is a sleep disordered breathing syndrome characterized by repetetive arousals resulting in sympathetic overactivity. We aimed to determine whether upper airway resistance syndrome is related to resistant hypertension. MethodsFourty patients with resistant hypertension were enrolled in the study. All patients underwent polysomnographic examination. All patients underwent 24 hours ambulatory blood pressure monitoring in order to rule out white coat syndrome and to monitor treatment efficiency. Fourty patients with resistant hypertension were enrolled in the study. All patients underwent polysomnographic examination. All patients underwent 24 hours ambulatory blood pressure monitoring in order to rule out white coat syndrome and to monitor treatment efficiency. ResultsTwenty-two patients (55%) were diagnosed with obstructive sleep apnoea and 14 patients (35%) were diagnosed with upper airway resistance syndrome according to American Sleep Disorders Association criteria. Upper airway resistance syndrome patients were younger and had a lower BMI when compared to other patients while there were no difference between the blood pressure levels and the number of antihypertensive drugs. Arousal index was determined to be positively correlated with systolic blood pressure level (p=0.034; r=0.746 ) while epword score and apnea-hypopnea index were independent of disease severity (p=0.435, r=0.323 and p=0.819, r= -0.097 respectively). Eight patients were treated with positive airway pressure treatment and blood pressure control was achieved in all whereas no pressure reduction was observed in 4 untreated patients. Twenty-two patients (55%) were diagnosed with obstructive sleep apnoea and 14 patients (35%) were diagnosed with upper airway resistance syndrome according to American Sleep Disorders Association criteria. Upper airway resistance syndrome patients were younger and had a lower BMI when compared to other patients while there were no difference between the blood pressure levels and the number of antihypertensive drugs. Arousal index was determined to be positively correlated with systolic blood pressure level (p=0.034; r=0.746 ) while epword score and apnea-hypopnea index were independent of disease severity (p=0.435, r=0.323 and p=0.819, r= -0.097 respectively). Eight patients were treated with positive airway pressure treatment and blood pressure control was achieved in all whereas no pressure reduction was observed in 4 untreated patients. ConclusionsWe concluded that upper airway resistance syndrome is a possible secondary cause of resistant hypertension and its proper treatment can result in dramatic blood pressure control. We concluded that upper airway resistance syndrome is a possible secondary cause of resistant hypertension and its proper treatment can result in dramatic blood pressure control.