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0903 A Novel Approach To Successful Identification And Treatment In Over 800 Patients With Pulmonary Artery Hypertension And SDB

Sleep (New York, N.Y.), 2018-04, Vol.41 (suppl_1), p.A335-A336 [Peer Reviewed Journal]

Sleep Research Society 2018. Published by Oxford University Press [on behalf of the Sleep Research Society]. All rights reserved. For permissions, please email: journals.permissions@oup.com 2018 ;Copyright © 2018 Sleep Research Society ;ISSN: 0161-8105 ;EISSN: 1550-9109 ;DOI: 10.1093/sleep/zsy061.902

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  • Title:
    0903 A Novel Approach To Successful Identification And Treatment In Over 800 Patients With Pulmonary Artery Hypertension And SDB
  • Author: Ghuge, R V
  • Subjects: Edema ; Hypertension ; Pulmonary arteries ; Sleep
  • Is Part Of: Sleep (New York, N.Y.), 2018-04, Vol.41 (suppl_1), p.A335-A336
  • Description: Abstract Introduction Pulmonary artery hypertension (PAH) is associated with Obstructive Sleep Apnea (OSA). PAH screening and treatment is scarcely performed at sleep consultations although many are referred for treatment of OSA due to pre-existing PAH. Clinical evaluation and confirmation of PAH needs to be performed at sleep centers as it can be an integral part of OSA testing and treatment. Methods Exertional shortness of breath, tricuspid and mitral regurgitation, peripheral edema and BP were documented during consultation. Polysomnography confirmed nocturnal hypertension and OSA severity. PAH confirmed with echocardiography. Titration polysomnography established IPAP/EPAP that controlled OSA and nocturnal hypertension. Home and clinic BP log, improvement of edema, TR and OSA (PAP downloads, symptom control) documented at followups. Echocardiography repeated in 6–12 months. Results Strong relationship observed between AHI (Mean AHI 43.89; SD 22.04) and peak systolic BP (range 130–241 mm of Hg, Mean 172.11 mm of Hg; SD 26.28). Relationship observed between AHI (Mean 43.89; SD 22.04; Range 7–112), Systolic BP index (Mean 42.10/hour of sleep; SD 32.25; Range 1–145) and resistant hypertension (range 130–241 mm of Hg, average 172.11 mm of Hg, SD 26.28) with a p-value <0.05. OSA controlled on BIPAP demonstrated average drop in systolic BP of 39.66 mm of Hg, range 31–51 mm of Hg and SD 9.17. Reduced anti-hypertensive medications upon treatment of OSA observed. Significant improvement in PAH by RVSP, TR/MR and subjective symptoms and clinical findings. Conclusion PAH, shortness of breath, peripheral edema and Tricuspid Regurgitation are commonly observed with OSA, nocturnal hypertension and resistant hypertension. OSA causes nocturnal hypertension, resistant hypertension and PAH. Strong correlation was observed between consistent regular BI-PAP (IPAP/EPAP) treatment of nocturnal hypertension with OSA and reduction in BP, reduction of PAH by echocardiogrpahy over 6–12 months. Resolution of PAH, resistant hypertension and OSA may reduce cardiovascular risk (including CHF, AF, right ventricular outflow tract arrhythmia, stroke). Support (If Any) Sleep-disordered breathing-induced systolic blood pressure variability: An independent predictor of increased cardiovascular risk and target organ damage. Ghuge RV. Sleep, volume 39, 2016.
  • Publisher: US: Oxford University Press
  • Language: English
  • Identifier: ISSN: 0161-8105
    EISSN: 1550-9109
    DOI: 10.1093/sleep/zsy061.902
  • Source: ProQuest One Psychology
    AUTh Library subscriptions: ProQuest Central
    Alma/SFX Local Collection
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