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) onthe incidence of cardiovascular events (CVE). However, the incidence of CVE among patients with bothobstructive sleep apnea (OSA) ans resistant hypertension (HR) has not been evaluated. Our objecti...

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Detalhes 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 Rio, Francisco, Montserrat, Josep María, Muriel Barrado, Alfonso Tomás, Oscullo, Grace, García-Ortega, Alberto, Posadas, Tomás, Campos-Rodríguez, Francisco, the Spanish Sleep Network
Formato: artículo
Fecha de publicación:2020
País:España
Recursos:Universidad Autónoma de Madrid
Repositorio:Biblos-e Archivo. Repositorio Institucional de la UAM
Idioma:inglés
OAI Identifier:oai:repositorio.uam.es:10486/692649
Acesso em linha:http://hdl.handle.net/10486/692649
https://dx.doi.org/10.1016/j.arbres.2019.12.006
Access Level:acceso abierto
Palavra-chave:CPAP
Cardiovascular events
Resistant hypertension
Stroke
Coronary heart disease
Cerebrovascular disease
Sleep apnea
Medicina
Descrição
Resumo:Background: There is some controversy about the effect of continuous positive airway pressure (CPAP) onthe incidence of cardiovascular events (CVE). However, the incidence of CVE among patients with bothobstructive sleep apnea (OSA) ans resistant hypertension (HR) has not been evaluated. Our objective wasto 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 andRH. All the patients were followed up every 3–6 months and the CVE incidence was measured. Patientsadherent to CPAP (at least 4 h/day) were compared with those with not adherent or those who had notbeen prescribed CPAP.Results: Valid data were obtained from 163 patients with 64 CVE incidents. Treatment with CPAP wasoffered to 82%. After 58 months of follow-up, 58.3% of patients were adherent to CPAP. Patients notadherent 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 theincidence 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 coronaryevents (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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