| Autor: |
Svedmyr, Sven, Hedner, Jan, Bailly, Sebastien, Fanfulla, Francesco, Hein, Holger, Lombardi, Carolina, Ludka, Ondrej, Mihaicuta, Stefan, Parati, Gianfranco, Pataka, Athanasia, Schiza, Sophia, Tasbakan, Sezai, Testelmans, Dries, Zou, Ding, Grote, Ludger, European Sleep Apnea Database (ESADA) study group, P, Steiropoulos, J, Verbraecken, E, Petiet, Trakada, Georgia |
| Předmět: |
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| Zdroj: |
European Heart Journal Open; Nov2023, Vol. 3 Issue 6, p1-10, 10p |
| Abstrakt: |
Aims: We analysed longitudinal blood pressure (BP) data from hypertensive obstructive sleep apnoea (OSA) patients in the European Sleep Apnea Database cohort. The study investigated the interaction between positive airway pressure (PAP)-induced BP change and antihypertensive treatment (AHT). Methods and results: Hypertensive patients with AHT [monotherapy/dual therapy n = 1283/652, mean age 59.6 ± 10.7/60.6 ± 10.3 years, body mass index (BMI) 34.2 ± 6.5/34.8 ± 7.0 kg/m2, apnoea–hypopnoea index 46 ± 25/46 ± 24 n/h, proportion female 29/26%, respectively] started PAP treatment. Office BP at baseline and 2- to 36-month follow-up were assessed. The interaction between AHT drug classes and PAP on BP was quantified and the influences of age, gender, BMI, co-morbidities, BP at baseline, and study site were evaluated. Following PAP treatment (daily usage, 5.6 ± 1.6/5.7 ± 1.9 h/day), systolic BP was reduced by −3.9 ± 15.5/−2.8 ± 17.7 mmHg in mono/dual AHT and diastolic BP by −3.0 ± 9.8/−2.7 ± 10.8 mmHg, respectively, all P < 0.0001. Systolic and diastolic BP control was improved following PAP treatment (38/35% to 54/46% and 67/67% to 79/74%, mono/dual AHT, respectively). PAP treatment duration predicted a larger BP improvement in the monotherapy group. Intake of renin–angiotensin blockers [angiotensin converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB)] alone or in any AHT combination was associated with better BP control. The AHT-dependent BP improvement was independent of confounders. Conclusion: In this pan-European OSA patient cohort, BP control improved following initiation of PAP. Longer PAP treatment duration, was associated with a favourable effect on BP. Our study suggests that ACEI/ARB, alone or in combination with other drug classes, provides a particularly strong reduction of BP and better BP control when combined with PAP in OSA. Graphical Abstract [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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