Email this article Efficacy of combined treatment of patients with severe obstructive sleep apnea and arterial hypertension of the second and third degree
- Authors: Sukmarova Z.N.1, Litvin A.Y.1, Chazova I.E.1, Rogoza A.N.1, Sukmarova ZN2, Litvin AY.2, Chazova IE2, Rogoza AN2
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Affiliations:
- Cardiological Research Center, Moscow
- Issue: Vol 83, No 5 (2011)
- Pages: 61-66
- Section: Editorial
- URL: https://ter-arkhiv.ru/0040-3660/article/view/30866
- ID: 30866
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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.
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, MoscowCardiological Research Center, Moscow
A Yu Litvin
Cardiological Research Center, MoscowCardiological Research Center, Moscow
I E Chazova
Cardiological Research Center, MoscowCardiological Research Center, Moscow
A N Rogoza
Cardiological Research Center, MoscowCardiological Research Center, Moscow
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