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Abstract: Background: There is some controversy about the effect of continuous positive airway pressure (CPAP) on the incidence of cardiovascular events (CVE). However, the incidence of CVE among patients with both obstructive sleep apnea (OSA) ans resistant hypertension (HR) has not been evaluated. Our objective was to analyze the long-term effect of CPAP treatment in patients with RH and OSA on the incidence of CVE.
Methods: Multi-center, observational and prospective study of patients with moderate-severe OSA and RH. All the patients were followed up every 3-6 months and the CVE incidence was measured. Patients adherent to CPAP (at least 4h/day) were compared with those with not adherent or those who had not been prescribed CPAP.
Results: Valid data were obtained from 163 patients with 64 CVE incidents. Treatment with CPAP was offered to 82%. After 58 months of follow-up, 58.3% of patients were adherent to CPAP. Patients not adherent to CPAP presented a non-significant increase in the total CVE incidence (HR:1.6; 95%CI: 0.96-2.7; p=0.07). A sensitivity analysis showed that patients not adherent to CPAP had a significant increase in the incidence of cerebrovascular events (HR: 3.1; CI95%: 1.07-15.1; p=0.041) and hypertensive crises (HR: 5.1; CI95%: 2.2-11.6; p=0.006), but the trend went in the opposite direction with respect to coronary events (HR: 0.22; CI95%: 0.05-1.02; p=0.053).
Conclusions: In patients with RH and moderate-severe OSA, an uneffective treatment with CPAP showed a trend toward an increase in the incidence of CVE (particularly neurovascular events and hypertensive crises) without any changes with respect to coronary events.
Fuente: Arch Bronconeumol (Engl Ed)
. 2021 Mar;57(3):165-171
Editorial: Elsevier Doyma
Fecha de publicación: 01/03/2021
Nº de páginas: 7
Tipo de publicación: Artículo de Revista
Url de la publicación: https://doi.org/10.1016/j.arbres.2019.12.006
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NAVARRO SORIANO, CRISTINA
MARTÍNEZ GARCÍA, MIGUEL ÁNGEL
SÁNCHEZ DE LA TORRE, MANUEL
CABALLERO ERASO, CANDELA
CAMBRILES, TRINIDAD DÍAZ
MASA, JUAN F.
MONICA GONZALEZ MARTINEZ
PEÑA, MÓNICA DE LA
GARCÍA RÍO, FRANCISCO
MONTSERRAT, JOSEP MARÍA
GARCÍA ORTEGA, ALBERTO
CAMPOS RODRÍGUEZ, FRANCISCO
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