Resistant Hypertension May Increase Sleep Apnea Risk

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 patients with hypertension. Of those with hypertension and sleep apnea, 5806 had resistant hypertension and 27 876 had nonresistant hypertension.

Multivariable odds ratios for sleep apnea were 1.16 (1.12-1.19), 3.57 (3.47-3.66) and 2.20 (2.15-2.25) for resistant hypertension vs nonresistant hypertension, BMI ≥ 30, and males, respectively. Sleep apnea in individuals with resistant hypertension had multivariate adjusted hazard ratios 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 individuals with sleep apnea and nonresistant hypertension.

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

Reference

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

This article originally appeared on Neurology Advisor