In a previous study, researchers found that in people with high blood pressure resistant to treatment who also have obstructive sleep apnea (OSA), the more severe their OSA, the higher their blood pressure.
The research was conducted by a team from the Hospital Universitari Arnau de Vilanova and other institutes.
The team examined 284 patients, ages 18 to 75, who were treated at hospitals in three countries—Spain, Singapore, and Brazil—for resistant high blood pressure.
Among all patients with high blood pressure, those with resistant high blood pressure, which requires three or more drugs to control, are at the greatest risk for a heart attack or other heart disease event.
The team found that 83.5% of patients with resistant hypertension had OSA, including 31.7% with mild OSA, 25.7% with moderate OSA, and 31.5% with severe OSA.
Obstructive sleep apnea was slightly more likely in men than women: 86.3% vs. 76%; however, the men were twice as likely to have severe obstructive sleep apnea.
Moreover, as the severity of obstructive sleep apnea increased, ambulatory blood pressure increased, particularly at night.
The average nighttime ambulatory blood pressure was 5.72 mmHg higher in those with severe obstructive sleep apnea compared to those without OSA.
The team believes that OSA plays an important role in the pathogenesis and prognosis of patients with resistant hypertension.
The finding shows a dose-response association between obstructive sleep apnea severity and blood pressure, especially during the nighttime period.
According to the authors, high blood pressure at night is a stronger predictor of cardiovascular risk than those whose blood pressure is high during the day.
Future work needs to directly test whether obstructive sleep apnea could cause high blood pressure in people with resistant hypertension.
The lead author of the study is Esther Sapiña-Beltrán. The study was published in the Annals of the American Thoracic Society.
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