Long -term Effect of CPAP Treatment on Cardiovascular Events in Patients With Resistant Hypertension and Sleep Apnea. Data From the HIPARCO-2 Study

Background: There is some controversy about the effect of continuous positive airway pressure (CPAP) on the incidence of cardiovascular events (CVE). However, the incidence of CVE among patients with both obstructive sleep apnea (OSA) ans resistant hypertension (HR) has not been evaluated. Our objec...

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Detalles Bibliográficos
Autores: Navarro-Soriano, Cristina, Martinez-Garcia, Miguel-Angel, Torres, Gerard, Barbé, Ferran, Sanchez-de la Torre, Manuel, Caballero-Eraso, Candela, Lloberes, Patricia, Diaz Cambriles, Trinidad, Somoza, Maria, Masa, Juan F., Gonzalez, Monica, Manas, Eva, de la Peña-Bravo, Mónica, Garcia-Rio, Francisco, Maria Montserrat, Josep, Muriel, Alfonso, Oscullo, Grace, Garcia-Ortega, Alberto, Posadas, Tomas, Campos-Rodríguez, Francisco, Spanish Sleep Network
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/19668
Acceso en línea:https://hdl.handle.net/20.500.13003/19668
Access Level:acceso abierto
Palabra clave:Continuous Positive Airway Pressure
Prospective Studies
Sleep Apnea, Obstructive
Humans
Sleep Apnea Syndromes
Hypertension
Hipertensión
Apnea Obstructiva del Sueño
Síndromes de la Apnea del Sueño
Humanos
Estudios Prospectivos
Presión de las Vías Aéreas Positiva Contínua
CPAP
Cardiovascular events
Resistant hypertension
Stroke
Coronary heart disease
Cerebrovascular disease
Sleep apnea
Descripción
Sumario:Background: There is some controversy about the effect of continuous positive airway pressure (CPAP) on the incidence of cardiovascular events (CVE). However, the incidence of CVE among patients with both obstructive sleep apnea (OSA) ans resistant hypertension (HR) has not been evaluated. Our objective was to analyze the long-term effect of CPAP treatment in patients with RH and OSA on the incidence of CVE. Methods: Multi-center, observational and prospective study of patients with moderate-severe OSA and RH. All the patients were followed up every 3-6 months and the CVE incidence was measured. Patients adherent to CPAP (at least 4 h/day) were compared with those with not adherent or those who had not been prescribed CPAP. Results: Valid data were obtained from 163 patients with 64 CVE incidents. Treatment with CPAP was offered to 82%. After 58 months of follow-up, 58.3% of patients were adherent to CPAP. Patients not adherent to CPAP presented a non-significant increase in the total CVE incidence (HR:1.6; 95%CI: 0.96-2.7; p = 0.07). A sensitivity analysis showed that patients not adherent to CPAP had a significant increase in the incidence of cerebrovascular events (HR: 3.1; CI95%: 1.07-15.1; p = 0.041) and hypertensive crises (HR: 5.1; CI95%: 2.2-11.6; p = 0.006), but the trend went in the opposite direction with respect to coronary events (HR: 0.22; CI95%: 0.05-1.02; p = 0.053).

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