Does Obstructive Sleep Apnea Influence Blood Pressure and Arterial Stiffness in Response to Antihypertensive Treatment?

Author(s):Show less -

Fatureto-Borges, Fernanda ^{[1, 2, 3]} ; Jenner, Raimundo ^[4] ; Costa-Hong, Valeria ^[2] ; Lopes, Heno F. ^{[2, 4]} ; Teixeira, Sandra H. ^[2] ; Marum, Elias ^[2] ; Giorgi, Dante A. M. ^[2] ; Consolim-Colombo, Fernanda M. ^{[2, 4]} ; Bortolotto, Luiz A. ^[2] ; Lorenzi-Filho, Geraldo ^[5] ; Krieger, Eduardo M. ^[6] ; Drager, Luciano F. ^{[2, 7]}

Affiliation

^[1] Fed Univ Grande Dourados, Fac Hlth Sci, Dourados, MS - Brazil

^[2] Univ Sao Paulo, Sch Med, Heart Inst InCor, Hypertens Unit, Ave Dr Eneas Carvalho de Aguiar 44, BR-05403900 Sao Paulo - Brazil

^[3] Univ Sao Paulo, Fac Med, Program Cardiol, Sao Paulo - Brazil

^[4] Univ Nove Julho UNINOVE, Dept Med, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Sch Med, Sleep Lab, Div Pulm, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Sch Med, Translat Res Program, Sao Paulo - Brazil

^[7] Univ Sao Paulo, Sch Med, Hypertens Unit, Div Renal, Sao Paulo - Brazil

• Document type: Journal article
• Source: Hypertension; v. 72, n. 2, p. 399-407, AUG 2018.
• Web of Science Citations: 1

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 mmHg) 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 mmHg; 18 months, -6.7 +/- 11.1 versus -1.2 +/- 10.6 mmHg; 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. (AU)

• FAPESP's process: 12/02953-2 - Impact of obstructive sleep apnea and sleep duration on the progression of cardiovascular diseases
• Grantee: Luciano Ferreira Drager
• Support Opportunities: Research Grants - Young Investigators Grants