Efficacy of combined treatment of patients with severe obstructive sleep apnea and arterial hypertension of the second and third degree


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Abstract

Aim. To assess efficacy of two- and three-component antihypertensive treatment (AHT) in patients with severe sleep apnea and arterial hypertension (AH) of the second and third degree in combination with CPAP therapy (continuous positive air pressure) and without it.
Material and methods. A total of 58 patients aged 55.5±9.6 years participated in the study. Clinical blood pressure (BP) before treatment was 172.0 (170.7-175.9)/100.0 (98.5-104.2) mm Hg, apnea/ hypopnea index was 26.3 episodes an hour. The patients received amlodipin in combination with walsartan in a dose 5-10/160 mg with addition of 25 mg hydrochlorothiaside if target BP was not achieved. This treatment was followed for 3 weeks by CPAP-therapy. Monitoring was made of clinical BP, central BP, target mean 24-h pressure.
Results. Despite a significant reduction of systolic arterial pressure/diastolic arterial pressure (by 30/ 14 mm Hg) as a result of antihypertensive treatment, this reduction was lower than in such patients without obstructive sleep apnea (by data from other investigators). CPAP-therapy reduced the number of resistant patients from 58 to 31%, patients with masked AH - from 19 to 11%, cases of arrhythmia - from 69 to 47%.
Conclusion. Multicomponent pathophysiologically sound AHT in hypertensive patients with severe obstructive sleep apnea was effective in less than 42% cases. The maximal effect was achieved in combined treatment with CPAP-therapy.

About the authors

Zul'fiya Nailevna Sukmarova

Aleksandr Yur'evich Litvin

Irina Evgen'evna Chazova

Anatoliy Nikolaevich Rogoza

Z N Sukmarova

Cardiological Research Center, Moscow

Cardiological Research Center, Moscow

A Yu Litvin

Cardiological Research Center, Moscow

Cardiological Research Center, Moscow

I E Chazova

Cardiological Research Center, Moscow

Cardiological Research Center, Moscow

A N Rogoza

Cardiological Research Center, Moscow

Cardiological Research Center, Moscow

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Copyright (c) 2011 Sukmarova Z.N., Litvin A.Y., Chazova I.E., Rogoza A.N., Sukmarova Z.N., Litvin A.Y., Chazova I.E., Rogoza A.N.

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