EFFECT OF CPAP TREATMENT ON THE INCIDENCE OF HYPERTENSIVE CRISES IN OBSTRUCTIVE SLEEP APNEA PATIENTS

<bold>Introduction:</bold> Over half of obstructive sleep apnea (OSA) patients have hypertension, and up to 30% of hypertensive individuals also suffer from OSA. OSA is related to increased blood pressure fluctuations, but its correlation with hypertensive crises (HTC) incidence and CPAP treatment's protective effect remains uncertain, which are the objectives of the present study. <bold>Methodology:</bold> Single-center prospective study in consecutive patients with suspected OSA, categorized into three groups: no OSA/mild OSA (AHI<15) without CPAP, OSA with CPAP, and moderate-severe OSA without /poorly tolerated CPAP (usage <4 hours). The primary outcome was the incidence of hypertensive crises (HTC) defined as acute symptoms and sudden, severe increase in blood pressure >180/110 mmHg. Cox survival analysis was assessed HTC-associated independent variables. <bold>Results:</bold> 752 patients (mean age 55.2; 62% male) were included; 46% were hypertensive. Among them, 262 (34.8%) had AHI<15 without CPAP; 156 (20.7%) had moderate-severe OSA with CPAP, and 334 had moderate-severe OSA without/poorly tolerated CPAP (44.5%). Median follow-up was 15 months. 48 incident HTC occurred. Cox analysis included: prior hypertension, age, sex, BMI, antihypertensive drugs, and OSA-CPAP groups. The table shows that the presence of previous hypertension, female gender, older age, and untreated moderate-severe OSA were risk factors for an incident HTC. However, CPAP treatment with good adherence normalized the risk in patients with moderate-severe OSA. <bold>Conclusion:</bold> Alongside age, female sex, and prior hypertension, moderate-severe OSA presence predicts future HTC risk, mitigated by proper CPAP treatment.