Long-term Effect of CPAP Treatment on Cardiovascular Events in Patients With Resistant Hypertension and Sleep Apnea. Data From the HIPARCO-2 Study

10-Year Risk for Cardiovascular Disease Associated with COMISA (Co-Morbid Insomnia and Sleep Apnea) in Hypertensive Subjects

“…Moreover, in hypertensive subjects, the presence of comorbid OSAS seems to promote the occurrence of hypertensive crises, resistance to antihypertensive medication and cardiovascular events (fatal and non-fatal) [7][8][9]. However, although the presence of OSAS seems to be associated with a less favorable cardiovascular outcome in hypertensive subjects, it has been shown that the OSAS treatments had a limited impact on blood pressure control and cardiovascular Life 2023, 13, 1379 2 of 12 prevention in this specific subgroup of patients [10,11]. Following these different elements, it therefore seems essential to carry out additional studies to allow a better identification of the potential cofactors involved in this higher cardiovascular risk associated with OSAS in hypertensive subjects.…”

The effect of continuous positive airway pressure on patients with resistant and refractory hypertension: lessons from the HIPARCO programme

“…There was a nonsignificant increase in the incidence of CVE in those patients without CPAP treatment (or with poor adherence), compared with those with good adherence (hazard ratio: 1.6; 95% CI, 0.96-2.7; P ¼ 0.07). However, a sensitivity analysis showed a significant increase in the incidence of cerebrovascular events (hazard ratio: 3.1; 95% CI, 1.07-15.1; P ¼ 0.04) and hypertensive crises (hazard ratio: 5.1; 95% CI, 2.2-11.6; P ¼ 0.006), although there was an opposite trend with respect to coronary events (hazard ratio: 0.22; 95% CI, 0.05-1.02; P ¼ 0.05) [14]. This phenomenon has already been verified in some of the observational and RCT studies of CPAP in patients with OSA.…”

“…Furthermore, a subgroup of patients with RfH was studied in detail. This entire project, in both its initial form as RCT (HIPARCO study) and its subsequent observational form (HIPARCO-2 study), resulted in the publication of seven manuscripts [10][11][12][13][14][15][16] that provided important information on the subject to the scientific community that can be summarized in the following points:…”

Clinical Phenotype of Resistant Hypertension Responders to Continuous Positive Airway Pressure Treatment: Results From the HIPARCO Randomized Clinical Trial

“…Since both these parameters are closely associated with cardiovascular complications, 7,8 this finding highlights still further the need to screen patients with RH for OSA, as CPAP treatment can indeed provide cardiovascular protection. 9 We have to acknowledge as a limitation in our study that the definition of RH conformed with the recommendations of 2008, 10 when the HIPARCO RCT was conducted.…”