ARTERIAL HYPERTENSION IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME: COMORBIDITY WITH A HIGH ADDITIVE CARDIOVASCULAR RISK

Abstract

The article presents the results of a research conducted with the aim of studying the features of hypertension, systolic-diastolic LV functions, antihypertensive therapy, depending on the presence of severe obstructive sleep apnea syndrome (OSA). According to the results of an 18-channel polysomnography (Somnolab-2, “Weinmann”, Germany), out of 126 men with hypertension (AH) of 1-3 degrees at the age of 50±5 years, 2 groups were formed: “AH + severe OSA” (n=64) and “AH” group (n=62). The number of cardiovascular disease (CVD) risk factors, the 10-year risk of CVD mortality according to SCORE, office blood pressure (BP) and its daily profile, left ventricle (LV) structure and function, and antihypertensive therapy were evaluated. It is established that with equal prevalence of diabetes and bad habits, patients with OSA had an “advantage” in visceral and abdominal obesity, hypercholesterolemia and hypertriglyceridemia. It has been found that in hypertensive patients, sleep apnea increases the risk of death for 10 years. Patients with severe OSA were characterized by a significantly longer duration of night BP load (189 and 52 min, respectively), a higher average night BP (126 and 108 mm Hg, respectively), and a worse daily BP profile (the “non-dippers” and “night-pickers” patients were 65% and 35%, versus 25% and 5% in the comparison group, respectively). In the group "AH + severe OSA" prevailed persons with LV hypertrophy. Patients of the main group were characterized by a large amount of antihypertensive pharmacotherapy and its low efficiency. Thus, Patients in whom hypertension is associated with severe OSA have more significant risk factors for CVD, a higher 10-year mortality risk, poorer LV structure, and lower efficacy of antihypertensive therapy compared to hypertensive individuals without sleep respiratory disorders.