N.А. Krushynska, Yu.M. Sirenko. Analysis of the occurrence of the obstructive sleep apnea syndrome in patients with resistant arterial hypertension

The aim – to assess occurrence of the obstructive sleep apnea (OSA) syndrome in patients with resistant arterial hypertension (AH).

Material and methods. One hundred forty nine consecutive hypertensive patients (average age 53.12±2.43 years) were enrolled in the study and divided into resistant hypertension group (n=90) and controlled blood pressure (BP) group (n=59). They underwent clinical and ambulatory blood pressure measurements, echocardiography, unattended somnography by dual-channel portable monitor device, applanation tonometry and estimation of daily sleepiness by Epworth Sleepiness Scale. Carotid-femoral (PWVcf) and carotid-radial (PWVcr) pulse wave velocity, central aortic pressure (CAP), left ventricular hypertrophy, blood pressure data and level of daily sleepiness were assessed.

Results. In subjects with resistant AH higher prevalence of OSA was founded (88.9 vs 66.1 %, Р<0.005) with domination of moderate and severe degree OSA (24.4 and 37.8 % respectively). Compared to patients with drug controlled AH, resistant hypertensive patients had higher PWVcf (11.93±0.65 vs 10.18±0.44 m/s, P<0.02), PWVcr (9.98±0.50 vs 8.45±0.32 m/s, P<0.05), central aortic pressure (139.40±5.56 vs 119.10±1.90 mm Hg, P<0.0001) and left ventricular mass index (123.98±8.30 vs 100.06±5.43 g/m2, P<0.05). Conclusion. Patients with resistant hypertension have higher prevalence of OSA and elevated arterial stiffness compared to the controlled hypertension group. OSA makes contribution to the development of drug resistance in hypertensive patients. Strict BP control is necessary to prevent severe vascular changes in the course of hypertensive disease.

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