Sleep Apnea Risk Elevated in Resistant Hypertension

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There was no difference in risk of stroke or mortality between hypertensive groups.

Patients with resistant hypertension may face an increased risk of sleep apnea, according to data published in Respirology.

Simran K. Bhandari, of Kaiser Permanente Los Angeles Medical Center in California, and colleagues conducted a large retrospective cohort study from January 1, 2006 through December 21, 2010 in 470,386 hypertensive adults (≥ 18 years).

Ultimately, sleep apnea was identified in 33,682 (7.2%) of participants with hypertension. Of those with hypertension and sleep apnea, 5806 had resistant hypertension and 27,876 had non-resistant hypertension.

Multivariable OR for sleep apnea was 1.16 (1.12, 1.19), 3.57 (3.47, 3.66) and 2.20 (2.15, 2.25) for resistant hypertension vs non-resistant hypertension, BMI ≥ 30, and males, respectively. Sleep apnea in participants with resistant hypertension had a multivariate adjusted HR of 1.24 (1.13, 1.36), 1.43 (1.28, 1.61), 0.98 (0.85, 1.12) and 1.04 (0.95, 1.14) for an ischemic heart event, congestive heart failure, stroke, and mortality, respectively, compared to participants with sleep apnea and non-resistant hypertension.

Overall, patients with resistant hypertension had a modest increase in risk of sleep apnea compared to those with non-resistant hypertension. Notably, risk of an ischemic heart event and congestive heart failure was greater in participants with resistant hypertension compared to those with non-resistant hypertension; however there was no observed difference in risk of stroke or mortality.

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Bhandari SK, Shi J, Molnar MZ, et al. Comparisons of sleep apnoea rate and outcomes among patients with resistant and non-resistant hypertension. Respirology. 2016; doi:10.1111/resp.12840.