Resistant hypertension and obstructive sleep apnea in the setting of kidney disease

• DOI: 10.1097/hjh.0b013e328351d08a
• Publication Date: 2012-03-01T09:17:49Z
• Authors: Khaled Abdel-Kader; Sheena Dohar; Nirav Shah; Manisha Jhamb; Steven E. Reis; Patrick Strollo; Daniel Buysse; Mark L. Unruh
• Keywords: Male; Sleep Apnea, Obstructive; Polysomnography; Drug Resistance; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Middle Aged; 16. Peace & justice; 3. Good health; Case-Control Studies; Hypertension; Humans; Kidney Failure, Chronic; Female; Sleep; Antihypertensive Agents; Aged

Objectives: To explore the relationship between obstructive sleep apnea (OSA) and resistant hypertension in chronic kidney disease (CKD) end-stage renal (ESRD). Methods: We examined parameters blood pressure (BP) 224 community-based, non-CKD participants from Sleep-SCORE study: 88 nondialysis-dependent CKD 95 ESRD participants. Unattended home polysomnography with standardized scoring protocols automated BP monitors were used. Resistant was defined as a of at least 140/90 mmHg despite three antihypertensive drugs. Results: Mean SBP groups significantly higher than that group [148.2 (23.8), 144.5 (26.7) vs. 132.2 (26.7), respectively; P < 0.0001] use more medications. The had rates (41.4, 22.6 6.7%, 0.0001). severity associated risk hypertension. Although severe [odds ratio (OR) 7.1, 95% confidence interval (CI) 2.2–23.2), there no significant association (OR 3.5, CI 0.8–15.4) or 1.2, 0.4–3.7) after accounting for case-mix. Conclusion: appeared robust ESRD. OSA may contribute to both be linked common underlying process such volume excess. Future studies patients should further characterize hypertension–OSA determine whether treatment mechanisms improve outcomes.