Hypertension treatment in patients with sleep apnea from the European Sleep Apnea Database (ESADA) cohort - towards precision medicine

被引:4
作者
Svedmyr, Sven [1 ,2 ]
Hedner, Jan [1 ,2 ]
Bonsignore, Maria Rosaria [3 ]
Lombardi, Carolina [4 ]
Parati, Gianfranco [4 ,5 ]
Ludka, Ondrej [6 ,7 ]
Zou, Ding [1 ,2 ]
Grote, Ludger [1 ,2 ]
机构
[1] Sahlgrens Univ Hosp, Dept Sleep Med, Gothenburg, Sweden
[2] Gothenburg Univ, Sahlgrenska Acad, Ctr Sleep & Vigilance Disorders, Medicinaregatan 8B,Box 421, S-40530 Gothenburg, Sweden
[3] Univ Palermo, Promise Dept, Palermo, Italy
[4] St Lukes Hosp, Dept Cardiovasc Neural & Metab Sci, IRCCS, Ist Auxol Italiano, Milan, Italy
[5] Univ Milano Bicocca, Dept Med & Surg, Milan, Italy
[6] Masaryk Univ, Univ Hosp Brno, Dept Internal Geriatr & Pract Med, Brno, Czech Republic
[7] Masaryk Univ, Med Fac, Brno, Czech Republic
关键词
antihypertensive treatment; beta-blocker; blood pressure control; diuretic; hypertension; obstructive sleep apnea; HEART-FAILURE;
D O I
10.1111/jsr.13811
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We recruited 5,970 patients with hypertension with obstructive sleep apnea (OSA) on current antihypertensive treatment from the European Sleep Apnea Database (ESADA) cohort. The group was subdivided into those receiving monotherapy (n = 3,594) and those receiving dual combined therapy (n = 2,376). We studied how major OSA confounders like age, gender, and body mass index as well as the degree of sleep apnea modified office systolic and diastolic blood pressure. Beta-blockers alone or in combination with a diuretic were compared with other antihypertensive drug classes. Monotherapy with beta-blocker was associated with lower systolic blood pressure, particularly in non-obese middle-aged males with hypertension. Conversely, the combination of a beta-blocker and a diuretic was associated with lower systolic and diastolic blood pressure in patients with hypertension with moderate-severe OSA. Systolic blood pressure was better controlled in female patients using this combined treatment. Our cross-sectional data suggest that specific clinical characteristics and type of antihypertensive medication influence the degree of blood pressure control in patients with hypertension with OSA. Controlled trials are warranted.
引用
收藏
页数:7
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