Do symptoms and comorbidities predict OSA severity in hypertension patients?

<bold>Background:</bold> The identification of clinically significant OSA may be improved by the inclusion of relevant comorbidities, symptoms and other objective variables such as age, sex and BMI. <bold>Objectives:</bold> To evaluate the relationship between symptoms, comorbidities, disease severity and other polysomnographic variables. <bold>Methods:</bold> Patients with hypertension referred to sleep clinics, between January 2022 and June 2023, were retrospectively analysed. Clinical and polysomnographic data was revised from medical records. Cardiovascular risk was calculated using the SCORE2 algorithm. <bold>Results:</bold> 76 hypertensive patients were analysed (53.9% female) with a mean age of 56 years and mean BMI of 30.8 kg/m2. Patients with severe OSA had a significantly higher BMI than patients with moderate OSA. Insomnia was more common in females (26.8% vs 5.7% males), and was related to severity, since patients with insomnia presented higher AHI and lower O2 saturations than those without (AHI 30.4/h vs 18.8/h). Hypertensive patients with any other cardiovascular comorbidities or with metabolic comorbidities had higher AHI, but without impact on severity. Those with severe OSA had higher SBP, DBP, ODI and T90 and lower O2 saturation compared to patients with mild and moderate OSA. CV risk did not demonstrate an impact on severity. <bold>Conclusion:</bold> In this study, patients presenting insomnia had more severe OSA. Severe OSA was also associated with highest SBP, DBP, ODI, T90, and lowest O2 saturation. In this population of hypertensive patients, a higher CV risk or the existence of comorbidities were not associated with a higher severity of OSA.