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. 2023 Nov 21;23(1):574.
doi: 10.1186/s12872-023-03595-z.

The association between blood pressure control and long-term cardiovascular outcomes in Hypertension coexistent with obstructive sleep apnea

Xiaoguang Yao #  1 , Nanfang Li #  2 , Mulalibieke Heizhati  1 , Yingchun Wang  1 , Yue Ma  3 , Run Wang  4 , Delian Zhang  1 , Qin Luo  1 , Junli Hu  1 , Menghui Wang  1 , Qing Zhu  4
Affiliations

The association between blood pressure control and long-term cardiovascular outcomes in Hypertension coexistent with obstructive sleep apnea

Xiaoguang Yao et al. BMC Cardiovasc Disord. .

Abstract

Purpose: The goal of blood pressure (BP) control will be lower when hypertensive patients have comorbidities that can affect the risk of cardiovascular diseases. But, the goal of BP control for hypertensive patients coexistent with obstructive sleep apnea (OSA) is not discussed, which is a special population at high risk of cardiovascular diseases.

Patients and methods: Using data from a retrospective study(Urumqi Research on Sleep Apnea and Hypertension (UROSAH) study, we enrolled 3267 participants who were diagnosed with hypertension and performed polysomnography during 2011-2013 to explore the association between BP control and long-term major adverse cardiovascular and cerebrovascular event (MACCE). Outcomes of interest was the levels of BP control, MACCE, cardiac event and cerebrovascular event. Then we calculated the cumulative incidence of MACCE and performed Cox proportional hazards with stepwise models.

Results: 379 of 3267 patients experienced MACCE during a median follow-up of 7.0 years. After full risk adjustment, BP control of 120-139/80-89mmHg was associated with the lowest risk of cerebrovascular event (HR: 0.53, 95%CI:0.35-0.82) rather than MACCE and cardiac event in the total cohort. The association did not change much in patients with OSA. When the SBP and DBP were discussed separately, the SBP control of 120-139mmHg or < 120mmHg was associated with the decreased incidence of MACCE and cerebrovascular event. When DBP control < 80 mm Hg, the risk of cerebrovascular event showed 54% decrease [(HR:0.46, 95%CI: 0.25-0.88)] in patients with hypertension and OSA.

Conclusion: In this retrospective study, antihypertensive-drug-induced office and home BP control at 120-139/80-89mmHg showed possible beneficial effect on incident MACCE. However, current results need to be verified in future studies.

Keywords: Diastolic blood pressure; Major adverse cardiovascular and cerebrovascular event; Obstructive sleep apnea; Stroke.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the study. UROSAH: Urumqi Research on Sleep Apnea and Hypertension; OSA:obstructive sleep apnea; CVDs: cardiovascular diseases
Fig. 2
Fig. 2
Kaplan-Meier curve of cardiovascular outccomes. Proportion survival of MACCE(2 A), stroke(2B), and CVEs(2 C) in different levels of blood pressure control. *MACCE: major adverse cardiovascular and cerebrovascular event; CVEs: cardiac event
See this image and copyright information in PMC

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