Peculiarity of hypotensive efficacy in hypertensive patients with desaturation signs of obstructive sleep apnea syndrome

Abstract

Aim. Го estimate the efficacy of 8-week antihypertensive monotherapy in patients with arterial hypertension (AH) regarding the presence of obstructive sleep apnea syndrome (OSAS). Material and methods. We analysed the results of 24-h blood pressure (BP) monitoring of 26 inpatients (mean age 54 ± 2 years) with mild (n = 18) and moderate (n = 8) AH before and after 8 weeks of treatment with 5-10 mg amlodipine or 50-100 mg of losartan once daily to assess blood pressure profile parameters. The patients underwent nocturnal monitoring of arterial oxygen saturation (pulsoximeter NONIN-8500 M, USA). The presence of OSAS was confirmed when a characteristic clinical picture was combined with the presence of significant (> 4%) sleep desaturation episodes > 15 episodes per hour or the presence of group desaturation episodes below 90%. Seven hypertensive patients with OSAS were assigned to group 1, nineteen patients without OSAS - to group 2. The differences in estimated parameters between the groups were tested by Mann-Whitney U test, the dynamics of BP profile parameters - by Wilcoxon matched pairs test. Results. In group 1 there were no significant differences by most of ВР profile parameters before and after antihypertensive treatment, except mean nocturnal systolic BP. In group 2 a significant hypotensive effect was seen by all parameters of BP profile except BP variability. Hypotensive efficacy in group 2 was 1.5-2 times higher vs group 1, but the difficulties were not significant. Conclusion. Antihypertensive therapy in hypertensive patients with OSAS is less effective than in those without OSAS but it is not uneffective.

Keywords

• arterial hypertension
• obstructive sleep apnea syndrome
• blood pressure
• monitoring
• oxygen saturation
• antihypertensive treatment