Among patients with resistant hypertension, the prevalence of obstructive sleep apnea was 82.2%, and moderate/severe OSA (55.5%) was associated with an adverse ambulatory blood pressure profile.
Cross-Sectional (n=422)
What is the prevalence of obstructive sleep apnea and its associated factors in patients with resistant hypertension?
There is a very high prevalence of obstructive sleep apnea (82.2%) among patients with resistant hypertension, which is associated with an adverse ambulatory blood pressure profile.
BACKGROUND: Obstructive sleep apnea (OSA) syndromes are strongly associated with resistant hypertension, although this has not been systematically examined. The aim of our study was to investigate the prevalence of OSA and its associated factors in a large cohort of resistant hypertensive patients. METHODS: A cross-sectional analysis with 422 resistant hypertensive patients (31.3% men; mean age = 62.4±9.9 years) submitted to a full-night polysomnography. The presence of OSA was defined by an apnea-hypopnea index (AHI) >5 per hour and moderate/severe OSA was defined by an AHI >15. Statistical analysis included bivariable comparisons between patients with and without moderate/severe OSA and logistic regressions to assess the independent correlates of OSA severity. RESULTS: Three-hundred forty-seven patients (82.2%) had OSA, and 234 patients (55.5%) had moderate/severe OSA. Patients with moderate/severe OSA were more frequently elderly and obese men with larger waist and neck circumferences, had higher prevalences of diabetes and left ventricular hypertrophy, and had higher proteinuria than patients with no/mild OSA. No difference was found in plasma aldosterone and renin activity. Nighttime systolic blood pressures and pulse pressures were higher in moderate/severe OSA, with lower nocturnal blood pressure fall. In multivariable logistic regression, male sex, older age, diabetes, obesity, increased waist and neck circumferences, and nighttime systolic blood pressure were the independent correlates of moderate/severe OSA. CONCLUSIONS: Resistant hypertensive patients had a very high prevalence of OSA, and patients with moderate/severe OSA had an adverse ambulatory BP profile, with higher nighttime systolic blood pressures and pulse pressures and higher prevalence of nondipping patterns. Other correlates of OSA severity were mainly demographic-anthropometric variables.
Muxfeldt et al. (Fri,) conducted a cross-sectional in Resistant hypertension (n=422). Obstructive sleep apnea vs. No or mild obstructive sleep apnea was evaluated on Prevalence of obstructive sleep apnea (AHI >5 per hour). Among patients with resistant hypertension, the prevalence of obstructive sleep apnea was 82.2%, and moderate/severe OSA (55.5%) was associated with an adverse ambulatory blood pressure profile.