| Title: |
Blood pressure control in hypertensive sleep apnoea patients of the European Sleep Apnea Database cohort - effects of positive airway pressure and antihypertensive medication |
| Authors: |
Svedmyr S.; Hedner J.; Bailly S.; Fanfulla F.; Hein H.; Lombardi C.; Ludka O.; Mihaicuta S.; Parati G.; Pataka A.; Schiza S.; Tasbakan S.; Testelmans D.; Zou D.; Grote L. |
| Contributors: |
Svedmyr, S; Hedner, J; Bailly, S; Fanfulla, F; Hein, H; Lombardi, C; Ludka, O; Mihaicuta, S; Parati, G; Pataka, A; Schiza, S; Tasbakan, S; Testelmans, D; Zou, D; Grote, L |
| Publisher Information: |
GB; Oxford University Press |
| Publication Year: |
2023 |
| Collection: |
Università degli Studi di Milano-Bicocca: BOA (Bicocca Open Archive) |
| Subject Terms: |
Antihypertensive treatment; ESADA; Hypertension; Obstructive sleep apnoea; Precision medicine |
| Description: |
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/m2, 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. |
| Document Type: |
article in journal/newspaper |
| File Description: |
ELETTRONICO |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/wos/WOS:001472205300025; volume:3; issue:6; journal:EUROPEAN HEART JOURNAL OPEN; https://hdl.handle.net/10281/553588 |
| DOI: |
10.1093/ehjopen/oead109 |
| Availability: |
https://hdl.handle.net/10281/553588; https://doi.org/10.1093/ehjopen/oead109 |
| Rights: |
info:eu-repo/semantics/openAccess ; license:Creative Commons ; license uri:http://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: |
edsbas.28BE303 |
| Database: |
BASE |