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

[EN]: [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. O...

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Detalles Bibliográficos
Autores: Navarro-Soriano, Cristina, Martínez-García, Miguel Ángel, Torres, Gerard, Barbé, Ferrán, Sánchez de la Torre, Manuel, Caballero-Eraso, Candela, Lloberes, Patricia, Díaz-Cambriles, Trinidad, Somoza, María, Masa, Juan F., González, Mónica, Mañas, Eva, Peña, Mónica de la, García-Río, Francisco, Montserrat, Josep M., Muriel, Alfonso, Oscullo, Grace, García-Ortega, Alberto, Posadas, Tomás, Campos-Rodríguez, Francisco
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:digital.csic.es:10261/237512
Acceso en línea:http://hdl.handle.net/10261/237512
Access Level:acceso abierto
Palabra clave:CPAP
Cardiovascular events
Resistant hypertension
Stroke
Coronary heart disease
Cerebrovascular disease
Sleep apnea
Presión positiva continua en las vías respiratorias
Eventos cardiovasculares
Hipertensión resistente
Accidente cerebrovascular
Enfermedad coronaria
Enfermedad cerebrovascular
Apnea del sueño
Descripción
Sumario:[EN]: [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). [Conclusions]: In patients with RH and moderate-severe OSA, an uneffective treatment with CPAP showed a trend toward an increase in the incidence of CVE (particularly neurovascular events and hypertensive crises) without any changes with respect to coronary events.

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