Obstructive Sleep Apnea Increases Cardiac Remodeling in Resistant Hypertension

Obstructive sleep apnea, graph, chart
Obstructive sleep apnea, graph, chart
Obstructive sleep apnea increases left ventricular hypertrophy in patients with treatment-resistant hypertension.

Obstructive sleep apnea (OSA) increases left ventricular hypertrophy (LVH) in patients with treatment-resistant hypertension, according to research presented at SLEEP 2019, held September 20-25, in Vancouver, Canada.

A consecutive cohort of patients with nonresistant hypertension and resistant hypertension was recruited from a hypertension outpatient unit in São Paulo, Brazil (n=50). Researchers identified OSA, defined as an apnea-hypopnea index of ≥15 events/h, in this cohort with a sleep monitoring test. Office blood pressure (BP), ambulatory BP monitoring (ABPM), and transthoracic echocardiography data were obtained.

Patients were subdivided into 4 groups: those with nonresistant hypertension without OSA, those with nonresistant hypertension with OSA, those with resistant hypertension without OSA, and those with resistant hypertension with OSA.

Individuals with resistant hypertension took more antihypertensive treatments than patients without resistant hypertension; however, no treatment differences were found for patients with and without OSA. The rate of OSA in the 22 patients with resistant hypertension was 55%, and the presence of OSA in these patients was associated with a trend toward having a higher LVH frequency compared with similar patients without OSA (92% vs 50%, respectively; P =.05).

No difference in the frequency of LVH was observed between patients with nonresistant hypertension with OSA vs without OSA (31% vs 33%, respectively; P =1.00). There was also no difference between patients with and without OSA in regard to office BP measurements and ABPM.

Limitations of the study included the small sample size as well as the analysis of data from a single center.

“Our preliminary data suggest that the presence of OSA may contribute to higher cardiac remodeling in patients with resistant hypertension,” the researchers wrote.

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Cabrini ML, Macedo TA, de Barros S, et al. Obstructive sleep apnea is associated with higher left ventricle hypertrophy frequency in patients with resistant hypertension. Presented at: SLEEP 2019; September 20-25, 2019; Vancouver, Canada. Abstract 271.