Association between arterial stiffness and sleep apnoea in patients with resistant hypertension

• Published in: Journal of human hypertension Vol. 36; no. 12; pp. 1078 - 1084
• Main Authors: Roderjan, Christian Nejm, de Hollanda Cavalcanti, Aline, Cortez, Arthur Fernandes, Chedier, Bernardo, Oliveira de Carvalho Carlos, Fernanda, de Souza, Fabio, Muxfeldt, Elizabeth Silaid
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.12.2022
• Subjects: Aged; Aorta; Apnea; Cardiovascular diseases; Cross-Sectional Studies; Female; Humans; Hypertension; Hypertension - complications; Hypertension - diagnosis; Male; Middle Aged; Multivariate analysis; Pulse Wave Analysis; Risk factors; Sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - diagnosis; Sleep disorders; Vascular Stiffness
• ISSN: 0950-9240; 1476-5527
• DOI: 10.1038/s41371-021-00642-0

Resistant Hypertension (RHT) is associated with a higher risk of Obstructive Sleep Apnoea (OSA). OSA and aortic stiffness (AS) measured by Pulse Wave Velocity (PWV) are independent risk factors for cardiovascular events. We assessed, in a cross-sectional study, the association between AS measured by PWV and OSA severity in patients with RHT. All patients were submitted to polysomnography, PWV measure and 24 h ABPM. Bivariate analysis compared patients with and without moderate/severe OSA. Multivariate analysis was performed to assess the independent correlates of moderate/severe OSA. A total of 376 patients were included, 31% were men with a mean age of 63 ± 10 years. Moderate/severe OSA was diagnosed in 214 patients (57%), 63 patients (17%) presented AS. Uncontrolled ABPM (true RHT) was found in 215 patients (57.2%) and among them 113 were diagnosed with moderate/severe OSA. Evaluating AS in patients with mild, moderate and severe apnoea, we observed a progressive increase in PWV (8.19 ± 1.55, 8.51 ± 1.84, 8.67 ± 1.68, respectively). Classifying them in 2 groups: (1) without apnoea/mild apnoea and (2) moderate/severe apnoea, we found higher values in group 2 (8.21 ± 1.52 m/s vs. 8.60 ± 1.75 m/s, p = 0.02), especially among true RHT patients (8.28 ± 1.62 vs. 8.81 ± 1.86, p = 0.029), women (8.13 ± 1.49 vs. 8.55 ± 1.73, p = 0.036), and uncontrolled nocturnal systolic BP (8.49 ± 1.63 vs. 8.58 ± 1.78, p = 0.04). In conclusion, in this RHT cohort, although with borderline results, the more severe the apnoea, the greater the arterial stiffness, mainly among women, true RHT and patients with an adverse nocturnal BP profile.