1001 Intersection of Obstructive Sleep Apnea and Treatment Resistant Hypertension

Abstract Introduction Obstructive sleep apnea (OSA) frequently coexists with hypertension and when left untreated can negatively impact cardiovascular health. Although treatment for OSA has shown modest effects on blood pressure, evidence suggests increased benefits for those with treatment-resistant hypertension (TRH). This study sought to describe demographics and clinical characteristics of patients newly diagnosed with OSA with comorbid TRH. Methods This retrospective study examined administrative claims data (commercial, Medicaid, Medicare Advantage) for patients with newly diagnosed OSA (ICD-10 diagnosis within 60 days of a sleep test) between October 2024 and May 2025. Adults (≥18 years) with a diagnosis code for TRH (ICD-10: I1A.0; newly available in October 2023) in the year prior to OSA diagnosis were included. Patients were required to have ≥1 year of data prior to their sleep test. Comorbidities and prescription fills were identified in the year prior using ICD-10 diagnosis codes and NDC codes, respectively. Patients were described overall and by gender. Results A total of 843 patients met inclusion criteria (47% female, mean age: 53 years). The majority of patients had either commercial insurance (59%) or Medicaid (30%), and 70% had either obesity or severe obesity. Patients had a high comorbidity burden, with an average of 3.5 other conditions. Cardiometabolic conditions were common, including hyperlipidemia (70%), type 2 diabetes (40%), coronary artery disease (26%), heart failure (19%), and cerebrovascular disease (14%) with similar rates across gender. In women vs men, rates of asthma (23% vs. 11%), depression (34% vs. 17%), anxiety (45% vs. 23%), and gastroesophageal reflux disease (41% vs. 29%) were particularly high. Approximately 60% of patients had prescription fills for ≥3 different classes of antihypertensive agents in the prior year. Conclusion Patients with OSA and comorbid TRH often present with high rates of cardiometabolic, mental health, and respiratory comorbidities, particularly among women. These findings provide insight into the complexity of overlapping conditions for patients with OSA and TRH. Given the harmful effects of untreated OSA on cardiovascular health, our results support consideration of screening, diagnosis, and treatment of OSA in TRH populations. Support (if any) Resmed