Arterial hypertension and obstructive sleep apnoea syndrome: treatment resistance and the role of autonomic dysfunction

Aim. To study the role of obstructive sleep apnoea syndrome (OSAS) in the development of treatment resistance in patients with arterial hypertension (AH). To assess the effects of autonomic nervous system (ANS) dysfunction, as one of the potential pathophysiological mechanisms of inadequate blood pr...

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Main Authors: V. V. Rostorotskaya, I. A. Elgardt, A. P. Ivanov, N. S. Sdobnyakova
Format: Article
Language:Russian
Published: «SILICEA-POLIGRAF» LLC 2012-10-01
Series:Кардиоваскулярная терапия и профилактика
Subjects:
Online Access:https://cardiovascular.elpub.ru/jour/article/view/1888
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author V. V. Rostorotskaya
I. A. Elgardt
A. P. Ivanov
N. S. Sdobnyakova
author_facet V. V. Rostorotskaya
I. A. Elgardt
A. P. Ivanov
N. S. Sdobnyakova
author_sort V. V. Rostorotskaya
collection DOAJ
description Aim. To study the role of obstructive sleep apnoea syndrome (OSAS) in the development of treatment resistance in patients with arterial hypertension (AH). To assess the effects of autonomic nervous system (ANS) dysfunction, as one of the potential pathophysiological mechanisms of inadequate blood pressure (BP) reduction in patients with AH and OSAS. Material and methods. The study included 365 ambulatory AH patients: 194 with OSAS and 161 with resistance to antihypertensive therapy after 6-15 months. The 24-hour BP monitoring (BPM) and 24-hour cardio-respiratory monitoring of electrocardiogram (ECG), with heart rate variability (HRV) analysis, were performed. Results. Among patients with AH and OSAS, most individuals had low antihypertensive therapy compliance. All parameters of 24-hour BPM in this group were lower than in OSAS-free hypertensives, and this difference was more pronounced in patients with lower treatment compliance, particularly for pulse BP and HR. HRV parameters correlated with apnoea-hypopnoea index (AHI) and BP levels during 24-hour BPM. However, in multivariate analyses, these correlations were observed only for HRV parameters and AHI. Conclusion. In AH patients, OSAS aggravates the clinical course of the disease. ANS dysfunction could be one of the mechanisms underlying the development of antihypertensive treatment resistance.
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spelling doaj.art-91752c46c60d43709a2a97e3b92038c22023-03-13T07:23:21Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01252012-10-01115111710.15829/1728-8800-2012-5-11-171603Arterial hypertension and obstructive sleep apnoea syndrome: treatment resistance and the role of autonomic dysfunctionV. V. Rostorotskaya0I. A. Elgardt1A. P. Ivanov2N. S. Sdobnyakova3Тверской клинический кардиологический диспансер, ТверьТверской клинический кардиологический диспансер, ТверьТверской клинический кардиологический диспансер, ТверьТверской клинический кардиологический диспансер, ТверьAim. To study the role of obstructive sleep apnoea syndrome (OSAS) in the development of treatment resistance in patients with arterial hypertension (AH). To assess the effects of autonomic nervous system (ANS) dysfunction, as one of the potential pathophysiological mechanisms of inadequate blood pressure (BP) reduction in patients with AH and OSAS. Material and methods. The study included 365 ambulatory AH patients: 194 with OSAS and 161 with resistance to antihypertensive therapy after 6-15 months. The 24-hour BP monitoring (BPM) and 24-hour cardio-respiratory monitoring of electrocardiogram (ECG), with heart rate variability (HRV) analysis, were performed. Results. Among patients with AH and OSAS, most individuals had low antihypertensive therapy compliance. All parameters of 24-hour BPM in this group were lower than in OSAS-free hypertensives, and this difference was more pronounced in patients with lower treatment compliance, particularly for pulse BP and HR. HRV parameters correlated with apnoea-hypopnoea index (AHI) and BP levels during 24-hour BPM. However, in multivariate analyses, these correlations were observed only for HRV parameters and AHI. Conclusion. In AH patients, OSAS aggravates the clinical course of the disease. ANS dysfunction could be one of the mechanisms underlying the development of antihypertensive treatment resistance.https://cardiovascular.elpub.ru/jour/article/view/1888артериальная гипертензиясиндром обструктивного апноэ снавегетативная нервная системарезистентность к лечению
spellingShingle V. V. Rostorotskaya
I. A. Elgardt
A. P. Ivanov
N. S. Sdobnyakova
Arterial hypertension and obstructive sleep apnoea syndrome: treatment resistance and the role of autonomic dysfunction
Кардиоваскулярная терапия и профилактика
артериальная гипертензия
синдром обструктивного апноэ сна
вегетативная нервная система
резистентность к лечению
title Arterial hypertension and obstructive sleep apnoea syndrome: treatment resistance and the role of autonomic dysfunction
title_full Arterial hypertension and obstructive sleep apnoea syndrome: treatment resistance and the role of autonomic dysfunction
title_fullStr Arterial hypertension and obstructive sleep apnoea syndrome: treatment resistance and the role of autonomic dysfunction
title_full_unstemmed Arterial hypertension and obstructive sleep apnoea syndrome: treatment resistance and the role of autonomic dysfunction
title_short Arterial hypertension and obstructive sleep apnoea syndrome: treatment resistance and the role of autonomic dysfunction
title_sort arterial hypertension and obstructive sleep apnoea syndrome treatment resistance and the role of autonomic dysfunction
topic артериальная гипертензия
синдром обструктивного апноэ сна
вегетативная нервная система
резистентность к лечению
url https://cardiovascular.elpub.ru/jour/article/view/1888
work_keys_str_mv AT vvrostorotskaya arterialhypertensionandobstructivesleepapnoeasyndrometreatmentresistanceandtheroleofautonomicdysfunction
AT iaelgardt arterialhypertensionandobstructivesleepapnoeasyndrometreatmentresistanceandtheroleofautonomicdysfunction
AT apivanov arterialhypertensionandobstructivesleepapnoeasyndrometreatmentresistanceandtheroleofautonomicdysfunction
AT nssdobnyakova arterialhypertensionandobstructivesleepapnoeasyndrometreatmentresistanceandtheroleofautonomicdysfunction