Long -term Effect of CPAP Treatment on Cardiovascular Events in Patients With Resistant Hypertension and Sleep Apnea. Data From the HIPARCO-2 Study

被引：27

作者：

Navarro-Soriano, Cristina ^{[1
]}

Martinez-Garcia, Miguel-Angel ^{[1
]}

Torres, Gerard ^{[2
]}

Barbe, Ferran ^{[3
,16
]}

Sanchez-de-la-Torre, Manuel ^{[16
,17
]}

Caballero-Eraso, Candela ^{[4
,16
]}

Lloberes, Patricia ^{[5
,16
]}

Diaz Cambriles, Trinidad ^{[6
]}

Somoza, Maria ^{[7
]}

Masa, Juan F. ^{[8
,16
]}

Gonzalez, Monica ^{[9
]}

Manas, Eva ^{[10
]}

de la Pena, Monica ^{[11
]}

Garcia-Rio, Francisco ^{[12
,16
]}

Maria Montserrat, Josep ^{[13
,16
]}

Muriel, Alfonso ^{[14
]}

Oscullo, Grace ^{[1
]}

Garcia-Ortega, Alberto ^{[1
]}

Posadas, Tomas ^{[1
]}

Campos-Rodriguez, Francisco ^{[15
,16
]}

机构：

[1] Hosp Univ & Politecn La Fe, Pneumol Dept, Valencia, Spain

[2] Hosp Univ Santa Maria, Internal Med Serv, Lleida, Spain

[3] IRBLleida, Hosp Arnau de Vilanova Santa Maria, Grp Traslat Res Resp Med, Lleida, Spain

[4] Hosp Univ Virgen del Rocio, Inst Biomed Seville IBiS, Resp Dept, Seville, Spain

[5] Hosp Univ Vall Hebron, Resp Dept, Barcelona, Spain

[6] Hosp Univ 12 Octubre, Resp Dept, Madrid, Spain

[7] Consorcio Sanitario Terrassa, Resp Dept, Barcelona, Spain

[8] Hosp Univ San Pedro de Alcantara, Resp Dept, Caceres, Spain

[9] Hosp Univ Marques de Valdecilla, Resp Dept, IDIVAL, Santander, Spain

[10] Hosp Univ Ramon y Cajal, Resp Dept, Madrid, Spain

[11] Hosp Univ Son Espases, Resp Dept, Palma De Mallorca, Spain

[12] Hosp Univ La Paz, Resp Dept, IdiPAZ, Madrid, Spain

[13] Hosp Clin IDIBAPS, Resp Dept, Barcelona, Spain

[14] Hosp Univ Ramon y Cajal, Biostat Unit, CIBERESP, IRYCIS, Madrid, Spain

[15] Hosp Univ Valme, Inst Biomed Seville IBiS, Resp Dept, Seville, Spain

[16] Ctr Invest Biomed Red Enfermedades Resp CIBERES, Madrid, Spain

[17] IRBLleida, Hosp Arnau de Vilanova Santa Maria, Grp Precis Med Chron Dis, Lleida, Spain

来源：

ARCHIVOS DE BRONCONEUMOLOGIA | 2021年 / 57卷 / 03期

关键词：

CPAP; Cardiovascular events; Resistant hypertension; Stroke; Coronary heart disease; Cerebrovascular disease; Sleep apnea; POSITIVE AIRWAY PRESSURE; CORONARY-HEART-DISEASE; BLOOD-PRESSURE; ISCHEMIC-STROKE; ASSOCIATION; MORTALITY; METAANALYSIS; MECHANISMS; PREVENTION; PROGNOSIS;

D O I：

10.1016/j.arbres.2019.12.006

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Background: There is some controversy about the effect of continuous positive airway pressure (CPAP) on the incidence of cardiovascular events (CVE). However, the incidence of CVE among patients with both obstructive sleep apnea (OSA) ans resistant hypertension (HR) has not been evaluated. Our objective was to analyze the long-term effect of CPAP treatment in patients with RH and OSA on the incidence of CVE. Methods: Multi-center, observational and prospective study of patients with moderate-severe OSA and RH. All the patients were followed up every 3-6 months and the CVE incidence was measured. Patients adherent to CPAP (at least 4 h/day) were compared with those with not adherent or those who had not been prescribed CPAP. Results: Valid data were obtained from 163 patients with 64 CVE incidents. Treatment with CPAP was offered to 82%. After 58 months of follow-up, 58.3% of patients were adherent to CPAP. Patients not adherent to CPAP presented a non-significant increase in the total CVE incidence (HR:1.6; 95%CI: 0.96-2.7; p = 0.07). A sensitivity analysis showed that patients not adherent to CPAP had a significant increase in the incidence of cerebrovascular events (HR: 3.1; CI95%: 1.07-15.1; p = 0.041) and hypertensive crises (HR: 5.1; CI95%: 2.2-11.6; p = 0.006), but the trend went in the opposite direction with respect to coronary events (HR: 0.22; CI95%: 0.05-1.02; p = 0.053).

引用

页码：165 / 171

页数：7

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