Blood pressure control in hypertensive sleep apnoea patients of the European Sleep Apnea Database cohort - effects of positive airway pressure and antihypertensive medication.
In: European Heart Journal Open, Jg. 3 (2023-11-01), Heft 6, S. 1-10
academicJournal
Zugriff:
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/m 2 , 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]
Copyright of European Heart Journal Open is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Titel: |
Blood pressure control in hypertensive sleep apnoea patients of the European Sleep Apnea Database cohort - effects of positive airway pressure and antihypertensive medication.
|
---|---|
Autor/in / Beteiligte Person: | 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 |
Zeitschrift: | European Heart Journal Open, Jg. 3 (2023-11-01), Heft 6, S. 1-10 |
Veröffentlichung: | 2023 |
Medientyp: | academicJournal |
DOI: | 10.1093/ehjopen/oead109 |
Schlagwort: |
|
Sonstiges: |
|