Sleep Apnea Patients with Resistant Hypertension More Likely to Experience Severe Cardiovascular Outcomes

A new study revealed that patients with resistant hypertension and also suffering from sleep apnea were more likely to experience ischemic heart events and congestive heart failure than patients with sleep apnea and non-resistant hypertension.

The study, published in the journal Respirology, suggests that the risk of cardiovascular outcomes is much greater in sleep apnea patients with resistant hypertension compared to those sleep apnea patients with non-resistant hypertension.

Resistant hypertension occurs when the blood pressure remain elevated beyond the normal levels despite concurrent use of three different classes of antihypertensive agents. Patients whose blood pressure is controlled by four or more medications are considered to have resistant hypertension.

For the study, the researchers followed 470,386 hypertensive individuals between January 1, 2006 and December 31, 2010. The rates of sleep apnea were measured for both resistant hypertensive patients and non-resistant hypertensive patients. The researchers performed multivariable logistic regression analyses to calculate the odds ratio of sleep apnea. Using Cox proportional hazard modeling, the researchers estimated the hazard ratios for cardiovascular and mortality outcomes of sleep apnea between resistant and non-resistant hypertension.

The researchers then discovered that 33,682 among the 470,386 participants have sleep apnea, with 9.6 percent of those were resistant hypertensive and 6.8 percent were non-resistant hypertensive.

Furthermore, the researchers found out that patients with sleep apnea and resistant hypertension is at an increase risk of ischemic heart events and congestive heart failure compared to patients with sleep apnea and non-resistant hypertension. However, the researchers did not find any significant difference in the hazard ratio of stroke and premature deaths in patients with resistant versus non-resistant hypertension.

"Our study suggests that the risk for cardiovascular outcomes is increased in sleep apnea patients with resistant hypertension compared with those with non-resistant hypertension," said Dr. Simran K. Bhandari, lead author of the study, in a statement.

According to the Centers for Disease Control and Prevention, about 70 million adults in the United States have high blood pressure, with only about a half have their hypertension under control. Hypertension increases the risk heart disease and stroke.