We recruited 5,970 hypertensive patients with obstructive sleep apnea (OSA) on current antihypertensive treatment from the European Sleep Apnea Database (ESADA) cohort. The group was subdivided into those receiving monotherapy (n = 3,594) and those receiving dual combined therapy (n = 2,376). We studied how major OSA confounders like age, gender, and body mass index as well as the degree of sleep apnea modified office systolic and diastolic blood pressure. Beta-blockers alone or in combination with a diuretic were compared with other antihypertensive drug classes. Monotherapy with beta-blocker was associated with lower systolic blood pressure, particularly in non-obese middle-aged males with hypertension. Conversely, the combination of a beta-blocker and a diuretic was associated with lower systolic and diastolic blood pressure in hypertensive patients with moderate-severe OSA. Systolic blood pressure was better controlled in female patients using this combined treatment. Our cross-sectional data suggest that specific clinical characteristics and type of antihypertensive medication influence the degree of blood pressure control in hypertensive OSA patients. Controlled trials are warranted.

Center for Sleep and Vigilance Disorders Sahlgrenska Academy Gothenburg University Gothenburg Sweden

Department of Internal Geriatrics and Practical Medicine University Hospital Brno and Medical Faculty Masaryk University Brno Czech Republic

Department of Medicine and Surgery University of Milano Bicocca Milan Italy

Department of Sleep Medicine Sahlgrenska University Hospital Gothenburg Sweden

Istituto Auxologico Italiano IRCCS Department of Cardiovascular Neural and Metabolic Sciences St Luke Hospital Milan Italy

PROMISE Department University of Palermo Palermo Italy

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