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THE ROLE OF BETA BLOCKER THERAPY FOR ISCHEMIC HEART DISEASE PREVENTION IN UNDIAGNOSED OBSTRUCTIVE SLEEP APNEA AND HYPERTENSION
Abstract   Open access   Peer reviewed

THE ROLE OF BETA BLOCKER THERAPY FOR ISCHEMIC HEART DISEASE PREVENTION IN UNDIAGNOSED OBSTRUCTIVE SLEEP APNEA AND HYPERTENSION

Peter Farjo, Kinjan Patel, Rohan Shah, Varun Badami, Sean Regner, Robert Stansbury and Stanley Schmidt
Journal of the American College of Cardiology, Vol.71(11 Supplement), pp.A140-A140
03/10/2018
DOI: 10.1016/S0735-1097(18)30681-8
url
https://doi.org/10.1016/S0735-1097(18)30681-8View
Published (Version of record) Open Access

Abstract

Background Obstructive sleep apnea (OSA) is associated with coronary artery disease (CAD) and heart failure. During apneic spells, sympathetic nerve activity increases which is thought to contribute to this association. Beta-blocker (BB) medications block this sympathetic nerve activity. We studied the role of beta blocker medication in reducing the cardiovascular events in patients with undiagnosed OSA and hypertension (HTN). Methods We analyzed data from one academic sleep center for patients with HTN and incident OSA but no prior cardiac disease history. Patients were followed retrospectively for five years from the date of their diagnostic polysomnography. Patients using BB medications were compared to those using another antihypertensive agent for our primary outcome of composite CAD events including unstable angina, NSTEMI, and STEMI. Secondary outcomes analyzed included new-onset atrial fibrillation, non-ischemic cardiomyopathy, left ventricular hypertrophy, chest pain hospitalization, valvular disease, and heart failure. Results A total of 658 patients (mean age: 58.3; 65% male) with HTN and incident OSA met our inclusion criteria. Of these, 283 (43%) were placed in the BB exposure group and 375 (57%) in the non-exposure group. The primary composite endpoint occurred in 53 patients (19%) in the exposure group and 83 patients (22%) in the non-exposure group. BB medications did not decrease the risk of ischemic heart disease events in our patients (relative risk [RR]: 0.85, 95% confidence interval [CI]: 0.62 to 1.15; p-value = 0.16). Composite components, secondary outcomes, and a subgroup analysis of mild, moderate, and severe OSA groups also did not show any significant relative risk reduction. Conclusion BB therapy is not associated with a risk reduction of ischemic heart disease events in patients with controlled HTN and undiagnosed OSA.
 Cardiology Cardiovascular Disease Heart Diseases Heart Failure Hypertension Ischemia Sleep Apnea Sleep Disorders Apnea Beta blockers Coronary artery disease Health risk assessment Sleep

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