Association of positive airway pressure adherence with the burden of antihypertensive medications in hypertensive patients with sleep apnoea: data from the IRSR Pays de la Loire Sleep Cohort.

<bold>Background:</bold> Whether PAP therapy adherence is associated with a reduction in oral antihypertensive drugs (OADs) burden remains unclear. <bold>Aims and objectives:</bold> This study aimed to assess the association between the adherence to PAP therapy and the delivery of OADs. <bold>Methods:</bold> Data from the IRSR Pays de la Loire Sleep Cohort were linked with the French health insurance database to identify OAD delivery in patients with prevalent hypertension at OSA diagnosis. OAD classification followed the 2023 international guidelines. The primary endpoint was the difference in the number of OAD classes at one year compared to baseline (mean delta OAD) in PAP-adherent patients (AP), defined as those with a median PAP use of ≥ 4 hours per day (h/d), versus PAP non-adherent patients (NAP), with PAP use < 4 h/d or PAP termination. <bold>Results:</bold> The analysis included 2205 patients (68.0% male) with a median age of 61 years (IQ1-Q3: 54-68), BMI of 32.4 kg/m2 (28.9-36.4), and initial AHI of 39/h (30-55). At OSA diagnosis, 33.6% were treated with 1 OAD, 32.8% with 2 OADs, 33.5% with 3 or more OADs. At one year follow up, 78.1% were AP (median PAP use 6.52 (5.52-7.76) h/d and 21.9% were NAP (PAP use 2.58 (1.41-3.34) h/d or PAP termination). Mean (SD) delta OAD was -0.02 (±0.58) and -0.04 (±0.7) in AP and NAP respectively (p=0.68). The number of OADs decreased by 11.1% and 13.5%, and increased by 10.5% and 12.1% in AP and NAP (p=0.11). <bold>Conclusions:</bold> In real-life settings, we found no association between adherence to PAP therapy of OSA and the number of OAD classes delivered at one year. Further subgroup analyses are ongoing.

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Published
2024-09-14
DOI
https://doi.org/10.1183/13993003.congress-2024.oa5439
Primary Topic
Obstructive Sleep Apnea Research
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article
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article

Association of positive airway pressure adherence with the burden of antihypertensive medications in hypertensive patients with sleep apnoea: data from the IRSR Pays de la Loire Sleep Cohort.

Abdelkebir Sabil, Sébastien Bailly, Acya Bizieux‐Thaminy, Sandrine Kerbrat et al.
Obstructive Sleep Apnea Research
article

Association of positive airway pressure adherence with the burden of antihypertensive medications in hypertensive patients with sleep apnoea: data from the IRSR Pays de la Loire Sleep Cohort.

Abdelkebir Sabil, Sébastien Bailly, Acya Bizieux‐Thaminy, Sandrine Kerbrat, François Roubille, Jean‐Pierre Mallet, Philippe Masson, Dany Jaffuel, Wojciech Trzépizur, Thierry Pigeanne, Erika Nogué, Margaux Blanchard, François Goupil, Nicolas Molinari, Frédéric Gagnadoux, Carole Hervé
article en

Abstract

<bold>Background:</bold> Whether PAP therapy adherence is associated with a reduction in oral antihypertensive drugs (OADs) burden remains unclear. <bold>Aims and objectives:</bold> This study aimed to assess the association between the adherence to PAP therapy and the delivery of OADs. <bold>Methods:</bold> Data from the IRSR Pays de la Loire Sleep Cohort were linked with the French health insurance database to identify OAD delivery in patients with prevalent hypertension at OSA diagnosis. OAD classification followed the 2023 international guidelines. The primary endpoint was the difference in the number of OAD classes at one year compared to baseline (mean delta OAD) in PAP-adherent patients (AP), defined as those with a median PAP use of ≥ 4 hours per day (h/d), versus PAP non-adherent patients (NAP), with PAP use < 4 h/d or PAP termination. <bold>Results:</bold> The analysis included 2205 patients (68.0% male) with a median age of 61 years (IQ1-Q3: 54-68), BMI of 32.4 kg/m2 (28.9-36.4), and initial AHI of 39/h (30-55). At OSA diagnosis, 33.6% were treated with 1 OAD, 32.8% with 2 OADs, 33.5% with 3 or more OADs. At one year follow up, 78.1% were AP (median PAP use 6.52 (5.52-7.76) h/d and 21.9% were NAP (PAP use 2.58 (1.41-3.34) h/d or PAP termination). Mean (SD) delta OAD was -0.02 (±0.58) and -0.04 (±0.7) in AP and NAP respectively (p=0.68). The number of OADs decreased by 11.1% and 13.5%, and increased by 10.5% and 12.1% in AP and NAP (p=0.11). <bold>Conclusions:</bold> In real-life settings, we found no association between adherence to PAP therapy of OSA and the number of OAD classes delivered at one year. Further subgroup analyses are ongoing.

Centre National de la Recherche Scientifique (FR), Inserm (FR), Université de Montpellier (FR), Université de Lille (FR), Centre Hospitalier Universitaire de Grenoble (FR), Centre Hospitalier Universitaire de Nantes (FR), Physiologie et Médecine Expérimentale du Coeur et des Muscles (FR), Hewlett-Packard (France) (FR), Centre Hospitalier Universitaire de Montpellier (FR), Centre Hospitalier Universitaire d'Angers (FR), Precision Spine (United States) (US), Centre Hospitalier du Mans (FR), Institute of Electrical and Electronics Engineers (FR), Institute for Neurosciences of Montpellier (FR), Unité de Recherche Pluridisciplinaire Sport, Santé, Société (FR), Institut Universitaire de Recherche Clinique (FR), Centre Hospitalier Départemental Vendée (FR), Hôpital Arnaud de Villeneuve (FR), Université d'été de Boulogne-sur-Mer (FR), Institut Universitaire Européen de la Mer (FR), Cidelec (France) (FR), Université d'Angers (FR), Université Grenoble Alpes (FR), Nantes Université (FR)
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Obstructive Sleep Apnea Research
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