| Popis: |
Objective: Few studies analyzed OSAS and resistant hypertension (RH) patients showing a reduction in blood pressure (BP) of 4-5mmHg for systolic (SBP) and 2-3mmHg for diastolic (DBP). We studied patients with moderate-severe OSAS (polysomograph recording, manual titration), compliant to CPAP therapy, monitored 48 hours ambulatory BP baseline, 3, 6 and 12 months. Methods: 35-65years old patients; exclusion criteria: insomnia, restless leg syndrome, parasomnias, secondary hypertension(HT), cardiovascular, respiratory, metabolic or acute uncontrolled pathologies, non-adherent to/changing antihypertensive medication. Results: 265 patients evaluated; 14 of 33 enrolled evaluated at 12 months: 9 men(64.3%), mean values: age 58.1±6.2 years, BMI 34.7±6.7kg/m 2 (similar at 1 year), Epworth 10.2±4.7/h, index of quality of life-SAQLI 4.8±1.6, diagnosis AHI 66.4±5.3/h, ODI 61.9±11.3/h, AHI post-titration 9.2 ±1.9, SBP baseline 161.7±22.1 mmHg, DBP 88.5±14.1 mmHg, diagnosed with HT for 12.8±11.3 years, CPAP compliance 87.9±14.1%, 5.9±1.1 h/night. After 1 year significant changes were recorded in almost all monitored parameters (except 48h average minimum BP both day and night), the decrease of BP: 23.9 mmHg for average/48h SBP and 12.0 mmHg for DBP. Conclusion: This study, included patients with uncontrolled severe RHT diagnosed for long time, is the first study that excluded other sleep associated pathologies with HT and followed patients for 1 year. We obtained significant reduction of BP superior to those previously reported in short term studies, highlighting the importance in terms of cardiovascular risk of proper CPAP therapy for a long period of time in these patients. |
