RT Journal Article
T1 Long-term Effect of CPAP Treatment on Cardiovascular Events in Patients With Resistant Hypertension and Sleep Apnea. Data From the HIPARCO-2 Study.
A1 Navarro-Soriano, Cristina
A1 Martínez-García, Miguel-Angel
A1 Torres, Gerard
A1 Barbé, Ferrán
A1 Sánchez-de-la-Torre, Manuel
A1 Caballero-Eraso, Candela
A1 Lloberes, Patricia
A1 Cambriles, Trinidad Díaz
A1 Somoza, María
A1 Masa, Juan F
A1 González, Mónica
A1 Mañas, Eva
A1 de la Peña, Mónica
A1 García-Río, Francisco
A1 Montserrat, Josep María
A1 Muriel, Alfonso
A1 Oscullo, Grace
A1 García-Ortega, Alberto
A1 Posadas, Tomás
A1 Campos-Rodríguez, Francisco
A1 on behalf the Spanish Sleep Network, 
K1 Accidente cerebrovascular
K1 Apnea del sueño
K1 CPAP
K1 Cardiovascular events
K1 Cerebrovascular disease
K1 Coronary heart disease
K1 Enfermedad cerebrovascular
K1 Enfermedad coronaria
K1 Eventos cardiovasculares
K1 Hipertensión resistente
K1 Presión positiva continua en las vías respiratorias
K1 Resistant hypertension
K1 Sleep apnea
K1 Stroke
AB There is some controversy about the effect of continuous positive airway pressure (CPAP) on the incidence of cardiovascular events (CVE). However, the incidence of CVE among patients with both obstructive sleep apnea (OSA) ans resistant hypertension (HR) has not been evaluated. Our objective was to analyze the long-term effect of CPAP treatment in patients with RH and OSA on the incidence of CVE. Multi-center, observational and prospective study of patients with moderate-severe OSA and RH. All the patients were followed up every 3-6 months and the CVE incidence was measured. Patients adherent to CPAP (at least 4h/day) were compared with those with not adherent or those who had not been prescribed CPAP. Valid data were obtained from 163 patients with 64 CVE incidents. Treatment with CPAP was offered to 82%. After 58 months of follow-up, 58.3% of patients were adherent to CPAP. Patients not adherent to CPAP presented a non-significant increase in the total CVE incidence (HR:1.6; 95%CI: 0.96-2.7; p=0.07). A sensitivity analysis showed that patients not adherent to CPAP had a significant increase in the incidence of cerebrovascular events (HR: 3.1; CI95%: 1.07-15.1; p=0.041) and hypertensive crises (HR: 5.1; CI95%: 2.2-11.6; p=0.006), but the trend went in the opposite direction with respect to coronary events (HR: 0.22; CI95%: 0.05-1.02; p=0.053). In patients with RH and moderate-severe OSA, an uneffective treatment with CPAP showed a trend toward an increase in the incidence of CVE (particularly neurovascular events and hypertensive crises) without any changes with respect to coronary events.
YR 2020
FD 2020-02-03
LK http://hdl.handle.net/10668/15063
UL http://hdl.handle.net/10668/15063
LA en
LA es
DS RISalud
RD Apr 6, 2025