PP.37.22: FACTORS RELATED TO OBSTRUCTIVE SLEEP APNEA IN PATIENTS WITH CONTROLLED AND RESISTANT HYPERTENSION REFERRED FOR POLYSOMNOGRAPHY. (June 2015)

• Record Type: Journal Article
• Authors: Hanus, K.; Miadziolko, M.; Prejbisz, A.; Kabat, M.; Paschalis-Purtak, K.; Pucilowska-Jankowska, B.; Plywaczewski, R.; Sliwinski, P.; Januszewicz, A.
• Is Part Of: Journal of hypertension. Volume 33(2015)Supplement 1
• Publication Date: 2015-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000468882.14154.80
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: The aim of study was to differentiate factors most related to obstructive sleep apnea (OSA) in a large cohort of patients with controlled, difficult to treat and resistant hypertension (HT) undergoing routine polysomnography (PSG) screening. Design and method: We included 309 consecutive HT patients (188 M, 121 F, mean age 51.3 ± 12.7, years) referred for PSG on the basis of one or more of the following clinical features suggestive for OSA: typical symptoms, resistant or difficult-to-treat HT, comorbidities known to be associated with OSA and high cardiovascular risk. Age, gender, neck circumference (increased -was defined as >/=43 cm M and >/=41 cm F), office blood pressure (BP) levels, presence of metabolic syndrome (MS) and its components (abdominal obesity, increased fasting glucose or diabetes, increased triglycerides, decreased HDL cholesterol levels), known cardiovascular disease (CVD) as well as OSA symptoms: presence of snoring, nycturia and daytime somnolence (Epworth Sleepiness Scale – ESS) were evaluated. All patients underwent PSG - the apnea/hypopnea index (AHI) > 15 events/h defined clinically important moderate-to-severe OSA was defined as AHI. Results: Moderate-to-severe OSA was diagnosed in 128 patients (41, 4%). Patients with OSA were characterized by higher age (56.0 ± 10.6 vs 48.0 ± 13.0 years; p < 0.001), higher frequency of males, MS and its components and increased neck circumference (50.5 vs. 27.2% p < 0.001). They were also characterized by higher median number of anti-HT medications (4 vs. 2; p < 0.001), higher frequency of resistant HT (51.8 vs 40.4%; p = 0.041), higher frequency of snoring (85.1 vs. 58.1%; p < 0.001) and nycturia (66.7% vs 43.9%; p = 0.001). There were no differences in ESS score and BP levels. In a multivariate model factors independently related with OSA were: older age (odds ratio (OR) 1.45 for 10 years increase; p = 0.033), increased neck circumference (OR 2.50; p = 0.012), treatment with 3 or more antihypertensive medication (OR 3.11; p = 0.004) and snoring (OR 2.78; p = 0.019). Conclusions: Older age, increased neck circumference, snoring and treatment with 3 or more antihypertensive medication were most strongly related with the presence of moderate-to-severe OSA in a large group of consecutive patients with controlled and resistant hypertension undergoing PSG.