Does Obstructive Sleep Apnea Influence Blood Pressure and Arterial Stiffness in Response to Antihypertensive Treatment?. Issue 2 (August 2018)

• Record Type: Journal Article
• Authors: Fatureto-Borges, Fernanda; Jenner, Raimundo; Costa-Hong, Valéria; Lopes, Heno F.; Teixeira, Sandra H.; Marum, Elias; Giorgi, Dante A.M.; Consolim-Colombo, Fernanda M.; Bortolotto, Luiz A.; Lorenzi-Filho, Geraldo; Krieger, Eduardo M.; Drager, Luciano F.
• Is Part Of: Hypertension. Volume 72:Issue 2(2018:Aug.)
• Publication Date: 2018-08
• Subjects: ambulatory blood pressure monitoring -- blood pressure -- hypertension -- polysomnography -- sleep apnea, obstructive -- treatment; Hypertension -- Periodicals; Hypertension -- Treatment -- Periodicals; 616.132005
• DOI: 10.1161/HYPERTENSIONAHA.118.10825
• Languages: English
• ISSNs: 0194-911X

Abstract

Abstract : Untreated obstructive sleep apnea (OSA) is common in patients with hypertension and may impair blood pressure (BP) and target-organ damage responses to antihypertensive therapy. In this study, we recruited hypertensive patients who underwent treatment with a 30-day regimen of hydrochlorothiazide 25 mg plus enalapril (20 mg BID) or losartan (50 mg BID) and were assessed with a baseline clinical evaluation, polysomnography, 24-hour ambulatory BP monitoring, and carotid-femoral pulse wave velocity. All the examinations except for polysomnography were repeated at 6 and 18 months of follow-up. We studied 94 hypertensive patients (mean age, 55±9 years). The frequency of OSA was 55%. Compared with baseline, we did not observe significant differences between groups in 24-hour BP, daytime systolic and diastolic BPs, or night-time systolic BP at 6 and 18 months. The BP control rate at 24 hours (<130/80 mm Hg) was similar between the groups (baseline, 42.3% versus 45.2%; 6 months, 46.9% versus 57.5%; 18 months, 66.7% versus 61.5%). However, patients with OSA had higher night-time diastolic BP decrease than did the non-OSA group (6 months, −4.9±11.8 versus −0.3±10.3 mm Hg; 18 months, −6.7±11.1 versus −1.2±10.6 mm Hg; P =0.027). There were no differences in the number and class of antihypertensive medications prescribed during follow-up. In terms of arterial stiffness, patients with OSA had higher pulse wave velocity than did patients without OSA at baseline (10.3±1.9 versus 9.2±1.7 m/s; P =0.024), but both groups had similar decreases in pulse wave velocity during follow-up. In conclusion, with combined antihypertensive treatment aimed at controlling BP, hypertensive patients with OSA had similar 24-hour BP and arterial stiffness to those without OSA. Abstract : Supplemental Digital Content is available in the text.