Hypertensive crisis in patients with obstructive sleep apnea-induced hypertension

Abstract

Background Hypertensive crisis is an urgent/emergency condition. Although obstructive sleep apnea (OSA) in resistant hypertension has been thoroughly examined, information regarding the risk factors and prevalence of hypertensive crisis in co-existing OSA and hypertension is limited. This study thus aimed to determine prevalence of and risk factors for hypertensive crisis in patients with hypertension caused by OSA. Methods The inclusion criteria were age of 18 years or over and diagnosis of co-existing OSA and hypertension. Those patients with other causes of secondary hypertension were excluded. Patients were categorized by occurrence of hypertensive crisis. Factors associated with hypertensive crisis were calculated using multivariate logistic regression analysis. Results There were 121 patients met the study criteria. Of those, 19 patients (15.70%) had history of hypertensive crisis. Those patients in hypertensive crisis group had significant higher systolic and diastolic blood pressure at regular follow-ups than those without hypertensive crisis patients (177 vs. 141 mmHg and 108 vs. 85 mmHg; p value < 0.001 for both factors). After adjusted for age, sex, and Mallampati classification, only systolic blood pressure was independently associated with hypertensive crisis with adjusted odds ratio (95% CI) of 1.046 (1.012, 1.080). Conclusions The prevalence of hypertensive crisis in co-existing OSA and hypertension was 15.70% and high systolic blood pressure or uncontrolled blood pressure associated with hypertensive crisis in patients with OSA-associated hypertension.

Intermittent Hypoxia and Atherosclerosis: From Molecular Mechanisms to the Therapeutic Treatment

“…A first retrospective study describing comorbidities in Hungarian and Romanian OSA patients showed that various diseases such as cardiovascular diseases (e.g., hypertension and arrhythmias), diabetes, and asthma were strongly associated with OSA severity in the whole study population and that OSA-CIH played an important role in it [ 29 ]. Khamsai et al found that patients with OSA combined with hypertension were much more likely to develop hypertensive crisis than the general population [ 30 ], greatly increasing the risk of various cardiovascular and cerebrovascular diseases. It was also noted that carotid artery intima-media thickness and AS-related inflammatory markers were significantly increased in hypertensive patients with combined OSA, confirming the damage to the vascular endothelium caused by this pathological phenomenon [ 31 ].…”

Factors associated with preventive behaviors for COVID-19 infection among healthcare workers by a health behavior model

“…Consequently, the results may vary with the stage of COVID-19 outbreak and the method of data collection is based only on the responses to the developed questionnaire which cannot verify the truth of the answer. Note that no specific clinical risk factors are evaluated such as obstructive sleep apnea [17][18][19][20][21][22]. Finally, there might be might be cultural differences or norm with other population such as general population [11,13].…”

Factors associated with favorable outcomes in acute severe stroke patients: A real‑world, national database study

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