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Resistant hypertension, sleep apnea elevate risk for ischemic events, HF
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Resistant hypertension conferred increased risk for sleep apnea, and patients with both conditions had greater risk for ischemic events and HF, according to new data.
Researchers conducted a retrospective cohort study between 2006 and 2010 of 470,386 adults with hypertension from the Kaiser Permanente Southern California database.
Participants were stratified by whether they had resistant or nonresistant hypertension, and ORs for sleep apnea were calculated for both groups.
The researchers also performed analyses adjusted for age, sex, race, BMI, chronic kidney disease and other comorbidities to determine HRs for ischemic heart events, congestive HF, stroke and mortality among those with sleep apnea.
The researchers reported that 7.2% of the overall cohort had sleep apnea, as did 9.6% of the resistant hypertension cohort and 6.8% of the nonresistant hypertension cohort.
Compared with those with nonresistant hypertension, those with resistant hypertension had greater odds for sleep apnea (OR = 1.16; 95% CI, 1.12-1.19).
Increased odds of sleep apnea were also present in those with BMI of at least 30 kg/m2 (OR = 3.57; 95% CI, 3.47-3.66) and in men (OR = 2.2; 95% CI, 2.15-2.25), according to the researchers.
Compared with individuals with sleep apnea and nonresistant hypertension, those with sleep apnea and resistant hypertension had increased risk for ischemic heart events (adjusted HR = 1.24; 95% CI, 1.13-1.36) and congestive HF (adjusted HR = 1.43; 95% CI, 1.28-1.61), the researchers wrote. However, there was no difference between the groups in stroke (adjusted HR = 0.98; 95% CI, 0.85-1.12) or mortality (adjusted HR = 1.04; 95% CI, 0.95-1.14).
“Our study suggests that the risk for [CV] outcomes is increased in sleep apnea patients with resistant hypertension compared with those with nonresistant hypertension,” Simran K. Bhandari, MD, from the division of nephrology and hypertension, Kaiser Permanente Los Angeles Medical Center, said in a press release. – by Erik Swain
Disclosure: The study was funded by Kaiser Permanente Southern California Research. Three researchers report being employed by Kaiser Permanente, and three report being affiliated with hospitals owned by Kaiser Permanente.
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