Obstructive Sleep Apnea and Endothelial Function in Patients With Resistant Hypertension
Condition: Obstructive Sleep Apnea; Secondary Hypertension
MeSH terms: Apnea; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Hypertension
Study type: Observational [Patient Registry]

Summary: 
      The purpose of this study is to determine the prevalence of obstructive sleep apnea and
      associate it with the endothelial function behavior in patients with resistant hypertension.
      Two groups will be evaluate, one presenting uncontrolled high blood pressure, and other, with
      controlled blood pressure by drugs.
    

Detailed description: 
      Introduction: Obstructive sleep apnea (OSA) is considered an independent risk factor for
      cardiovascular disease. There is evidence that individuals with OSA may have increased
      inflammatory mediators, changes in the metabolic profile, increased sympathetic activity with
      consequent elevation of blood pressure (BP) and endothelial dysfunction. Resistant
      hypertension (RH) is defined as uncontrolled blood pressure (BP ≥ 140/90mmHg) despite the
      current use of three hypotensive drugs at full doses, including a diuretic, or the need for
      >3 medications to control BP. OSA has been reported as the most common secondary cause of
      high blood pressure maintenance.

      Objective: To determine the prevalence of OSA and associate it with the endothelial function
      behavior in patients with resistant hypertension comparing to those with BP controlled by
      medication.

      Methods: A cross-sectional study involving 40 hypertensive patients (20 with resistant
      hypertension and 20 with controlled BP), irrespective of race or gender, with ages between 18
      and 75 years. BP was measured by oscillometric method on automatic device. Endothelial
      function was assessed by peripheral arterial tonometry (PAT) by EndoPAT2000® and the OSA
      diagnosis also through PAT, using the portable device WatchPAT200®. Anthropometric evaluation
      was performed through measurements of waist, hip and neck circumference, body mass index,
      waist to height ratio (WHtR), and body composition assessed by bioelectrical impedance.
      Statistical analyzes were performed by GraphPad Prism software.
    

Intervention name(s): WatchPAT
Intervention type(s): Device
Intervention description(s): BP was measured by oscillometric method on automatic device. Endothelial function was assessed by peripheral arterial tonometry (PAT) by EndoPAT2000® and the OSA diagnosis also through PAT, using the portable device WatchPAT200®. Anthropometric evaluation was performed through measurements of waist, hip and neck circumference, body mass index, waist to height ratio (WHtR), and body composition assessed by bioelectrical impedance.
Other intervention name(s): WatchPAT 200 - Itamar Medical; EndoPAT 2000 - Itamar Medical; Omron 742INT
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Hypertensive patients, from the Hypertension Clinic of UERJ
      
Keywords: Obstructive sleep apnea; Resistent hypertension; Endothelial function; Blood pressure