The need of higher CPAP pressure in a population with obstructive sleep apnea (OSA) and refractory hypertension (RHT) versus controlled hypertension-a retrospective study

RATIONALE: RHT is common in obese patients, refractoriness among them is frequently caused by OSA. A previous study held in our clinic showed that patients with RHT had higher CPAP failure rate. METHOD: After exclusion criteria (central/mixed SAS, obesity-hypoventilation/overlap syndrome, obstructive/restrictive respiratory dysfunction, CPAP failure) applied to 214 SAS patients with HT, we studied 34 patients with controlled HT and RHT(demographics, anthropometrics, symptoms, comorbidities, sleep study9s: Chi test,T-test,Pearson). The 2 groups were similar in terms of smoking habit and antihypertensive treatment. RESULTS: Controlled HT-27 patients(79.4%): 19 men(70.4%), 8 women(29.6%); RHT-7 patients(20.6%): 4 men(57.1%), 3 women(42.9%).RHT patients were younger(49.6±8.8 vs 58.4±12.1years,p CONCLUSIONS: After CPAP failure exclusion, patients with OSA and RHT still need higher CPAP values, which does not correlate with obesity. RHT patients will cost more the health system due to their cardiovascular comorbidities, young age and sleepiness. Further studies have to elucidate the need of higher CPAP pressures in RTH patients.