TY - JOUR
T1 - The Effect of Obstructive Sleep Apnea on Subclinical Target Organ Damage in Patients With Resistant Hypertension
AU - Dalmases, Mireia
AU - Sánchez-de-la-Torre, Manuel
AU - Martinez, Dolores
AU - Minguez, Olga
AU - Vaca, Rafaela
AU - Pascual, Lydia
AU - Aguilá, Maria
AU - Gracia-Lavedan, Esther
AU - Benitez, Ivan D.
AU - Pinilla, Lucía
AU - Cortijo, Anunciación
AU - Gort-Paniello, Clara
AU - Bascompte Claret, Ramon
AU - Martinez-Garcia, Miguel Ángel
AU - Mediano, Olga
AU - Romero Peralta, Sofía
AU - Fortuna-Gutierrez, Ana Maria
AU - Ponte Marquez, Paola
AU - Drager, Luciano F.
AU - Cabrini, Mayara
AU - Masa, Juan Fernando
AU - Corral Peñafiel, Jaime
AU - Vázquez, Susana
AU - Abad, Jorge
AU - García-Rio, Francisco
AU - Casitas, Raquel
AU - Lee, Chi Hang
AU - Barbé, Ferran
AU - Torres, Gerard
PY - 2025/3
Y1 - 2025/3
N2 - Introduction: Among all patients with hypertension, those with resistant hypertension (RH) have the highest rates of subclinical organ damage (SOD). The prevalence of obstructive sleep apnea (OSA) is high in RH patients, and it could contribute to SOD. We aimed to investigate how OSA and its treatment are related to SOD in a large cohort of RH patients. Methods: This is an ancillary analysis to the SARAH study, a multicentre observational cohort aiming to evaluate the impact of OSA on RH. Individuals with RH who were undergoing a sleep study and have information on at least one of the SOD variables (vascular, cardiac or renal damage) were selected. Patients were followed-up for three years. Results: In total, 503 subjects were included. The participants were predominantly male, obese, and the median (IQR) apnea–hypopnea index (AHI) was 15.5 (7.90–31.5) events/h. No differences in the presence of vascular or cardiac damage were observed between OSA and non-OSA patients. A lower estimated glomerular filtration rate (eGFR) was observed in participants with OSA than in those without OSA, with an adjusted effect of −8.69 mL/min/1.73 m2 (−13.59, −3.79; p value < 0.001). Kidney damage was also greater in subjects with OSA, with an adjusted OR (95% CI) of 1.77 (1.09, 2.87; p value = 0.02). The eGFR showed a linear dose–response relationship with OSA severity. Among patients treated with CPAP, lower eGFR values were observed in noncompliant subjects. Conclusions: OSA could contribute to worsening renal function in patients with RH. No compliance with CPAP was associated with lower values of eGFR.
AB - Introduction: Among all patients with hypertension, those with resistant hypertension (RH) have the highest rates of subclinical organ damage (SOD). The prevalence of obstructive sleep apnea (OSA) is high in RH patients, and it could contribute to SOD. We aimed to investigate how OSA and its treatment are related to SOD in a large cohort of RH patients. Methods: This is an ancillary analysis to the SARAH study, a multicentre observational cohort aiming to evaluate the impact of OSA on RH. Individuals with RH who were undergoing a sleep study and have information on at least one of the SOD variables (vascular, cardiac or renal damage) were selected. Patients were followed-up for three years. Results: In total, 503 subjects were included. The participants were predominantly male, obese, and the median (IQR) apnea–hypopnea index (AHI) was 15.5 (7.90–31.5) events/h. No differences in the presence of vascular or cardiac damage were observed between OSA and non-OSA patients. A lower estimated glomerular filtration rate (eGFR) was observed in participants with OSA than in those without OSA, with an adjusted effect of −8.69 mL/min/1.73 m2 (−13.59, −3.79; p value < 0.001). Kidney damage was also greater in subjects with OSA, with an adjusted OR (95% CI) of 1.77 (1.09, 2.87; p value = 0.02). The eGFR showed a linear dose–response relationship with OSA severity. Among patients treated with CPAP, lower eGFR values were observed in noncompliant subjects. Conclusions: OSA could contribute to worsening renal function in patients with RH. No compliance with CPAP was associated with lower values of eGFR.
KW - Continuous positive airway pressure
KW - Glomerular filtration rate
KW - Obstructive sleep apnea
KW - Renal function
KW - Resistant hypertension
KW - Subclinical organ damage
UR - http://www.scopus.com/inward/record.url?scp=85203824726&partnerID=8YFLogxK
U2 - 10.1016/j.arbres.2024.07.018
DO - 10.1016/j.arbres.2024.07.018
M3 - Article
AN - SCOPUS:85203824726
SN - 0300-2896
VL - 61
SP - 147
EP - 155
JO - Archivos de Bronconeumologia
JF - Archivos de Bronconeumologia
IS - 3
ER -