The Effect of Obstructive Sleep Apnea on Subclinical Target Organ Damage in Patients With Resistant Hypertension.

Autor:	Dalmases M; Sleep Unit, Department of Pulmonary Medicine, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain., Sánchez-de-la-Torre M; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Group of Precision Medicine in Chronic Diseases, Hospital Nacional de Parapléjicos, IDISCAM, Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, Spain., Martinez D; Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Lleida, Spain., Minguez O; Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Lleida, Spain., Vaca R; Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Lleida, Spain., Pascual L; Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Lleida, Spain., Aguilá M; Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Lleida, Spain., Gracia-Lavedan E; Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Lleida, Spain., Benitez ID; Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Lleida, Spain., Pinilla L; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Lleida, Spain., Cortijo A; Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Lleida, Spain., Gort-Paniello C; Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Lleida, Spain., Bascompte Claret R; Cardiology Department, Hospital Arnau de Vilanova, Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Lleida, Spain., Martinez-Garcia MÁ; Hospital Universitario y Politécnico La Fe, Respiratory Department, Valencia, Spain., Mediano O; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Sleep Unit, Pneumology Department, Hospital Universitario de Guadalajara, Guadalajara, Spain., Romero Peralta S; Sleep Unit, Pneumology Department, Hospital Universitario de Guadalajara, Guadalajara, Spain., Fortuna-Gutierrez AM; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Sleep Unit, Respiratory Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain., Ponte Marquez P; Internal Medicine, Emergency Department, Hypertension and Cardiovascular Risk Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Bellaterra, Spain., Drager LF; Unidades de Hipertensão, Instituto do Coração (InCor) e Divisão de Nefrologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil., Cabrini M; Unidades de Hipertensão, Instituto do Coração (InCor) e Divisão de Nefrologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil., Masa JF; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Hospital San Pedro de Alcantara, Respiratory Dept, Cáceres, Spain., Corral Peñafiel J; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Hospital San Pedro de Alcantara, Respiratory Dept, Cáceres, Spain., Vázquez S; Hypertension and Vascular Risk Unit, Nephrology Department, Hospital del Mar, Parc de Salut Mar, IMIM, UAB-UPF, Barcelona, Spain., Abad J; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Respiratory Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain., García-Rio F; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Respiratory Department, Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz, Madrid, Spain., Casitas R; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Respiratory Department, Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz, Madrid, Spain., Lee CH; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Barbé F; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Lleida, Spain., Torres G; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Lleida, Spain. Electronic address: gtorres@gss.cat.
Jazyk:	English; Spanish; Castilian
Zdroj:	Archivos de bronconeumologia [Arch Bronconeumol] 2024 Sep 03. Date of Electronic Publication: 2024 Sep 03.
DOI:	10.1016/j.arbres.2024.07.018
Abstrakt:	Introduction: Among all patients with hypertension, those with resistant hypertension (RH) have the highest rates of subclinical organ damage (SOD). The prevalence of obstructive sleep apnea (OSA) is high in RH patients, and it could contribute to SOD. We aimed to investigate how OSA and its treatment are related to SOD in a large cohort of RH patients. Methods: This is an ancillary analysis to the SARAH study, a multicentre observational cohort aiming to evaluate the impact of OSA on RH. Individuals with RH who were undergoing a sleep study and have information on at least one of the SOD variables (vascular, cardiac or renal damage) were selected. Patients were followed-up for three years. Results: In total, 503 subjects were included. The participants were predominantly male, obese, and the median (IQR) apnea-hypopnea index (AHI) was 15.5 (7.90-31.5)events/h. No differences in the presence of vascular or cardiac damage were observed between OSA and non-OSA patients. A lower estimated glomerular filtration rate (eGFR) was observed in participants with OSA than in those without OSA, with an adjusted effect of -8.69mL/min/1.73m 2 (-13.59, -3.79; p value<0.001). Kidney damage was also greater in subjects with OSA, with an adjusted OR (95% CI) of 1.77 (1.09, 2.87; p value=0.02). The eGFR showed a linear dose-response relationship with OSA severity. Among patients treated with CPAP, lower eGFR values were observed in noncompliant subjects. Conclusions: OSA could contribute to worsening renal function in patients with RH. No compliance with CPAP was associated with lower values of eGFR. (Copyright © 2024 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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