Comparison of blood pressure levels between continuous positive airway pressure-adherent and non-adherent patients with obstructive sleep apnea syndrome.

Comparación de la presión arterial entre pacientes con síndrome de apnea obstructiva del sueño con y sin apego al tratamiento con presión positiva continua en la vía aérea

Abstract

OBJECTIVE: To compare blood pressure levels in patients with obstructive sleep apnea syndrome and hypertension, treated with continuous positive airway pressure (CPAP) devices with adequate vs inadequate adherence.

MATERIALS AND METHODS: An observational, analytical, retrospective, and cross-sectional study including patients 18 years of age and older with obstructive sleep apnea syndrome by means of polysomnography and systemic arterial hypertension under pharmacological therapy and treatment with CPAP devices for at least three months.

RESULTS: There were included 513 patients with obstructive sleep apnea syndrome; systemic arterial hypertension prevalence was 61.8% (n = 317). Overall CPAP adherence was 57.1% (n = 293), and 59.3% (n = 188) within the hypertensive subgroup. Global blood pressure control (systolic ≤ 139 and diastolic ≤ 89 mmHg, optimal, normal, and normal-high categories) was observed in 71% of the population. When comparing the groups according to adherence, the group with adequate use (n = 188) showed a higher rate of blood pressure control compared to the non-adherent group (n = 129; 74% vs 65%); however, this difference did not reach statistical significance (p = 0.064).

CONCLUSIONS: A clinical trend towards better blood pressure control was observed in patients adherent to CPAP (74% vs 65%). Although this difference did not reach statistical significance, these findings suggest a potential cardiovascular benefit. However, inherent biases and unmeasured confounders limit these findings, requiring further prospective research.

KEYWORDS: Obstructive sleep apnea syndrome; Continuous positive airway pressure; Antihypertensive; Hypertension.